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.
101 year old female, admitted to the hospital with foot and toe pain. Patient had a cool pulseless foot.
Asymptomatic slowly enlarging internal iliac artery aneurysm
94 year old female, worsening right toe and foot pain. Seen by primary care and diagnosed as having gout.