83 year old male, Type I Diabetes, end stage renal disease, living independently who was told he needed a below knee amputation. The patient had a failed popliteal to dorsalis pedis artery bypass graft. An attempt at endovascular repair also failed. The patient came for a second opinion. A second at endovascular repair was successful. The patient had a transmetarsal amputation which healed. He continued to live on his own for another 4 years, enjoying his life with both legs.
67 year old male, type1 diabetic, with painful ulceration at the tip of the second toe. Patient did not toe amputation.
62 year old female with 2 months of short distance claudication and rest pain at night
Current physiologic testing for ulcer perfusion may fail to identify patients with ischemia