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.
Renal vein stent placed for Nutracker Syndrome was placed too far into the IVC and causing pain. Stent was partially removed.
Short distance claudication and rest pain secondary to thrombosed popliteal artery aneurysm treated endovasculary.
Current physiologic testing for ulcer perfusion may fail to identify patients with ischemia