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.
The tip of a hydrophilic wire was fractured and subsequently retrieved during the crossing of a distal anterior tibial artery near occlusion
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.
83 year old developed non healing ulcer left foot after occlusion of a known popliteal artery aneursym