61 year old male, diabetic, developed a lateral right foot ulcer after a pedicure. The posterior tibial artery pulse was palpable. No dorsalis pedis artery pulse. Monofilament testing showed decreased sensation typical of diabetic neuropathy. Angiography showed distal PTA stenosis and severe stenosis in the proximal lateral plantar artery - the blood supply to the wound. Interestingly, the anterior tibial artery had variant anatomy where it terminates into medial and lateral tarsal branches with no true dorsalis pedis artery. This variant has been noted to predispose the foot to ischemia.
67 year old male, type1 diabetic, with painful ulceration at the tip of the second toe. Patient did not toe amputation.
Endovascular therapy of external iliac and common femoral artery occlusion with 31 month follow up
94 year old female, worsening right toe and foot pain. Seen by primary care and diagnosed as having gout.