101 year old female, admitted to the hospital with foot and toe pain. Patient had a cool pulseless foot. CT Angiography showed multilevel peripheral arterial disease. No physiologic testing was done. Patient told the pain was due to an ingrown toe nail and sent home on narcotics. The patient went to podiatry and was correctly diagnosed as having critical limb ischemia.
94 year old female, worsening right toe and foot pain. Seen by primary care and diagnosed as having gout.
Percutaneous bypass graft for severe critical limb ischemia