46 year old male, type 1 diabetes, with ulcers on several toes. Patient had palpable pulses at the ankle. Angiography shows occlusion of the distal dorsalis pedis artery and of the distal lateral plantar artery. The deep plantar artery and plantar arch were reconstructed and the wounds healed.
Percutaneous bypass graft for severe critical limb ischemia
94 year old female, worsening right toe and foot pain. Seen by primary care and diagnosed as having gout.
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.