Wound Healing in a CLTI Patient with Severe Infrapedal Arterial Occlusion Treated with Rheocarna: A GLASS Inframalleolar P2 Modifier Case

Abstract

 In patients with advanced chronic limb-threatening ischemia, the Global Limb Anatomic Staging System（GLASS）P2 modifier is characterized by the absence of target vessels below the ankle, making endovascular therapy and surgical revascularization extremely challenging. This “no-option anatomic pattern” is associated with low wound-healing rates. We report a case in which adjunctive low-density lipoprotein cholesterol adsorption therapy using Rheocarna was administered to a patient with the most severe anatomical phenotype（GLASS P2 modifier）, resulting in successful wound healing.