Management of Critical Limb Ischemia with Hyperbaric Oxygen Therapy

Monday, March 31, 2025

5:00 PM – 5:05 PM CT

Location: Music City Center, 205 BC

Abstract Presenter(s)

Noah G. Banoub

Medical Student
Kaiser Permanente Bernard J. Tyson School of Medicine, United States

Author/Co-author(s)

SD

Sophia M. Durney, BS (she/her/hers)

Medical Student
Kaiser Permanente Bernard J Tyson School of Medicine, United States
AB

Alok Bhatt, MD

Assistant Program Director of Vascular and Interventional Integrated Residency
Kaiser Permanente physician, United States

Learning Objectives: To review surgical management of critical limb ischemia using endovascular therapy and adjunct hyperbaric oxygen therapy. To explore different measurements related to the efficacy of hyperbaric oxygen therapy.

Background: Critical limb ischemia is the most advanced stage of peripheral arterial occlusive disease, often requiring revascularization to improve extremity perfusion and decrease the risk of amputation {1}. Hyperbaric oxygen therapy has been used to promote wound healing in ischemic tissue, potentially playing an important role in treating patients with postoperative infection caused by gangrene or necrotic tissue. Various metrics have been used to investigate the effectiveness of hyperbaric oxygen therapy, including transcutaneous oxygenation and peripheral circulation {2},{3}. In this educational exhibit, we will provide an overview of the usage of hyperbaric oxygen therapy as an adjunct treatment modality to manage critical limb ischemia.

Clinical Findings/Procedure Details:

This exhibit will:

Review the principles and evidence behind hyperbaric oxygen therapy.

Describe the antimicrobial mechanisms of hyperbaric oxygen therapy on ischemia and infection.

Review appropriate patient selection for hyperbaric oxygen therapy.

Explore the various measurements used to quantify effectiveness of hyperbaric oxygen therapy, such as transcutaneous oxygen measurements and skin perfusion pressures.

Conclusion and/or Teaching Points: Patients undergoing endovascular intervention for critical limb ischemia are still at risk for postoperative major adverse limb events {4}. The utilization of hyperbaric oxygen therapy as part of periprocedural care may provide improved outcomes when compared to isolated surgical management. Given the high mortality rates of this severe form of peripheral artery disease, it is relevant to explore outcomes of adjunct therapies used to treat ischemia.