{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:32:18Z","timestamp":1791217938322,"version":"4.1.0"},"reference-count":26,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Chronic limb-threatening ischemia (CLTI) is a severe condition associated with high mortality and amputation rates, particularly in patients with diabetes, renal failure, or severe vascular disease. In cases where revascularization fails or is not possible, adjunctive therapies can improve the treatment outcomes. Therefore, this single-center retrospective study aimed to evaluate the effectiveness of low-density lipoprotein\/fibrinogen apheresis (Rheocarna\u00ae) in promoting wound healing in patients with no-option CLTI, focusing on large wounds. Methods: We examined the data of 32 CLTI ulcers treated with Rheocarna\u00ae from 2021 to 2024. Results: The outcomes in 25 cases (78.1%) were rated as excellent or good, and the outcomes of 11 (73.3%) wound, ischemia, and foot infection (WIfI) wound-3 ulcers were excellent or good. Overall, 75% of the CLTI ulcers achieved wound healing without major amputation. Predictive factors for successful wound healing included age, baseline skin perfusion pressure, and wound grade (WIfI classification). A skin perfusion pressure threshold of 28.5 mmHg (WIfI ischemic grade 3) was a significant predictor of positive outcomes. Conclusions: Our results support the use of Rheocarna\u00ae as a viable adjunctive therapy in managing refractory large ischemic ulcers and preventing major amputations.<\/jats:p>","DOI":"10.3390\/jcm14082589","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T12:05:56Z","timestamp":1744200356000},"page":"2589","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Effectiveness of Low-Density Lipoprotein\/Fibrinogen Apheresis in Promoting Wound Healing of No-Option Chronic Limb-Threatening Ischemia Foot Ulcers with Wound, Ischemia, and Foot Infection (WIfI) Wound Grade 3: A Single-Center Retrospective Analysis"],"prefix":"10.3390","volume":"14","author":[{"given":"Miki","family":"Fujii","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo 160-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruna","family":"Hirai","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rei","family":"Tomyo","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Juntendo University Nerima Hospital, Tokyo 177-8521, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Mizobuchi","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai","family":"Omori","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6370-0915","authenticated-orcid":false,"given":"Rica","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan"},{"name":"Division of Regenerative Therapy, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S5","DOI":"10.1016\/j.jvs.2006.12.037","article-title":"TASC II Working Group Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II)","volume":"45","author":"Norgren","year":"2007","journal-title":"J. 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