Blue Toe from Ulcerated Popliteal Artery Plaque

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…

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Pedal Loop Reconstruction

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

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Misdiagnosed Painful Toe

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.​

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Internal Iliac Artery Aneurysm

Internal iliac artery aneurysms are rare. In most instances, they do not cause symptoms unless they rupture. Mortality after rupture is about 50%. Aneurysm under 25-30mm in size can be watched with serial imaging – typically CT. Aneurysms > 25-30mm should be treated to avoid rupture. Endovascular repair is preferred to open surgery as it…

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Groin Pseudoaneurysm

Advantages of an endovascular approach versus an open surgical procedure are clear – safer, faster recovery, no general anesthesia, almost no risk of infection, and no large groin incision.

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Thrombosed Popliteal Artery Aneurysm

A 75-year-old male with severe PAD. Prior endovascular AAA repair. Prior right leg bypass graft times 2. Both failed. Prior right leg percutaneous bypass graft 9 months ago for CLI. Worsening left leg claudication and rest pain. The patient has a thrombosed bilobed popliteal artery aneurysms. Recanalization failed using conventional techniques even with antegrade and retrograde…

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AortoIliac Occlusive Disease

62-year-old male, heavy smoker, with a long history of leg pain with walking. Lumar spine fusion was done with no improvement in symptoms. Exercise ABI’s demonstrated severe peripheral arterial disease. CT angiography showed occlusion of the infrarenal abdominal aorta, bilateral common iliac arteries, left external iliac artery, and severe right external iliac artery disease. Recanalization…

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Debilitating Leg Pain

A 59-year-old male with short distance exercise-induced left leg pain. The pain was severe and was interfering with the patients actively living. He was seen and treated for neurogenic claudication for several months without any improvement. The patient had palpable pulses in the left foot, which was mistaken as indicating he had good blood flow…

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Right Flank Pain With Exertion

A 50-year-old female has right flank pain that occurs when walking. Extensive workup for nonvascular causes was done, and severe stenosis in the abdominal aorta was found. During further workup, the patient had typical symptoms of leg claudication. However, it was their flank pain that was causing the most concern. Flank pain due to claudication…

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