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.
Endovascular repair of an anastomic stenosis of a aortobifemoral bypass graft using JetStream atherectomy
Sharp recanailziation of a heavily calcified SFA occlusion
59 year old male, smoker, sudden onset of pain and discoloration of the right 3rd toe.