94 year old female, worsening right toe and foot pain. Seen by primary care and diagnosed as having gout. The clinical findings of critical limb ischemia - dry scaly skin, nail changes, absent pulses and a punched out ulcer on the 2nd toe - were ignored. Popliteal artery occlusion treated with atherectomy.
Current physiologic testing for ulcer perfusion may fail to identify patients with ischemia
46 year old male, type 1 diabetes, with ulcers on several toes. Patient had palpable pulses at the ankle.
Severe aortoiliac occlusion with rest pain and short distance claudication treated with novel CERAB technique using covered stent grafts.