The patient was initially seen for ischemic ulceration of right foot toe ulcers and was found to have 2 left popliteal artery aneurysms. The patient declined treatment of the aneurysms at that time. 18 months later the aneurysms occluded and the patient developed ulcerations of several left toes with rest pain. Revascularizion was performed using a Jetstream atherectomy of the occluded popliteal artery and stenting. Drug eluding stenting of the proximal anterior tibial artery severe stenosis. Ulcer healing occurred and the patient is doing well 21 months later.
Nutcracker syndrome is one of the causes of secondary pelvic congestion syndrome.
87 year old with severe left leg claudication limiting ability to walk more than 100 feet
82 year old male, heavy smoker, developed right heel ulcer during rehab after a femur fracture.