38 year old female with deep venous thrombosis 14 years ago while on birth control pills. Second DVT shortly after discontinuing anti-coagulation. Hematologic work up showed the patient to have Protein S deficiency. Patient suffered with severe post thrombotic syndrome eventually resulting in venous ulceration 8 years ago. Patient suffered with a chronic ulcer that was eventually healed after venoplasty of the femoral and popliteal veins.
Current physiologic testing for ulcer perfusion may fail to identify patients with ischemia
64 year old male, type 1 diabetes, with a prior femoral to politeal bypass graft and a subsequent poplileal to tibial bypass graft.
67 year old male, type1 diabetic, with painful ulceration at the tip of the second toe. Patient did not toe amputation.