59 year old male, smoker, sudden onset of pain and discoloration of the right 3rd toe. Comprehensive workup for an embolic source demonstrated a focal plaque in the popliteal artery. Catheter angiography showed the ulcerated plaque. Directional atherectomy using a SilverHawk atherectomy device was performed. Patients symptoms resolved and at last follow up 2 years later, the patient had no recurrence.
Current physiologic testing for ulcer perfusion may fail to identify patients with ischemia
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.
The tip of a hydrophilic wire was fractured and subsequently retrieved during the crossing of a distal anterior tibial artery near occlusion