51 year old male with Type 1 Diabetes and a lateral foot ulcer for 4 months. Patient received standard wound care with slow progression of the ulcer and was offered a below knee amputation. Skin perfusion testing showed normal perfusion. CT angiography demonstrated severe stenosis at the origin of the anterior and posterior tibial arteries with variant pedal artery anatomy. Catheter angiography underestimated the degree of stenosis. Intravascular US was performed which clearly showed the degree of luminal loss. Stenting with drug eluding stents was performed. Ulcer healing was achieved 3 months after revascularization.
59 year old male with short distance exercise induced left leg pain. Pain was severe and was interfering with the patients actively living.
55 year old female that underwent a skin biopsy with non healing of the biopsy site at 7 weeks.
67 year old male, type1 diabetic, with painful ulceration at the tip of the second toe. Patient did not toe amputation.