Effect of Blood Flow by Botulinum Toxin Injection for Severe Peripheral Artery Occlusive Disease

Inclusion Criteria:

1. Age ≥ 20 years old

2. Patients who have a lower extremity wound among those who have been diagnosed withmoderate or severe lower extremity ischemia

3. Patients who are unable to perform additional procedures (angioplasty, etc.) byperforming peripheral vascular examination and CT angiography

4. Wound size ≥ 1x1cm2 to ≤ 3x3cm2

5. Patients who can follow the clinical trial procedure well and abide by the visitschedule

6. Written informed consent to participate in the study after having fully understoodthe contents of the protocol and restrictions.

Exclusion Criteria:

1. Patients with diseases that can affect neuromuscular function, such as myastheniagravis, Eaton-Lamberton syndrome, amyotrophic lateral sclerosis, and motorneuropathy

2. Within 4 weeks before screening, aminoglycoside antibiotics, curare-like agents, ordrugs that inhibit neuromuscular function (muscle relaxants, anticholinergics,benzodiazepines, benzamides, tetracyclines, Rinco Those who have taken mycinantibiotics, etc.)

3. Those taking aspirin, NSAIDs or anticoagulants within 7 days before screening

4. Those who have received botulinum toxin preparations within 3 months beforescreening

5. Angiography or CT angiography If one or more of the three major blood vessels in thelower extremity are open

6. Cases in which blood flow to the lower extremities can be preserved by performingballoon angioplasty even if all three major blood vessels in the lower extremity areblocked

7. Those who are currently taking steroids or immunosuppressants that affect wounds, orthose who have taken them within one month of screening

8. Those who have applied injection drugs or wound coverings that help improve woundswithin 1 week of screening

9. Women who are pregnant, lactating, planning to become pregnant during the clinicalperiod, or women of childbearing age who are not using available contraceptivemethods (women of childbearing age must be negative in the pregnancy test prior toinjection).

10. Those who are allergic or sensitive to botulinum toxin

11. Those who have participated in another clinical trial within 30 days beforescreening or those who have not passed the half-life of the investigational productof the clinical trial that they participated in, whichever is longer.

12. Those who are not suitable for this clinical trial under the judgment of otherinvestigators