Posts Tagged ‘TOE’
Painful Right Toe
94-year-old female, worsening right toe and foot pain. Seen by primary care and diagnosed as having gout. The clinical findings of critical limb ischemia – dry scaly skin, nail changes, absent pulses and a punched out ulcer on the 2nd toe – were ignored. Popliteal artery occlusion treated with atherectomy.
Read MoreDPA Wire Fragment Retrieval
82 year old male with non healing ulcer of the great toe. Severe peripheral arterial disease with long segment occlusion of the posterior tibial artery and severe disease of the distal anterior tibial artery. During crossing of the severe stenosis of the ATA the tip of the hydrophilic wire was bent and then fracture while…
Read More2nd Toe Ulcer
67 year old male, type1 diabetic, with painful ulceration at the tip of the second toe. Patient did not toe amputation. Although toe amputation sounds simple it leads to biomechanical changes in the foot which can cause progressive deterioration and further more significant amputations. Angiography showed the severe stenosis in the plantar arch. The plantar…
Read MoreFailed Bypass Graft
64 year old male, type 1 diabetes, with a prior femoral to politeal bypass graft and a subsequent poplileal to tibial bypass graft. The later graft failed and the patient was told there were no other options to restore blood flow. Endovascular reconstruction of the popliteal artery and tibioperoneal trunk restored blood flow and wound…
Read MoreBlue 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…
Read MorePedal 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
Read MoreRest Pain in Elderly Female
104 year old female, treated 3 years earlier for critical limb ischemia of the right foot. Now presents with a 2 month history of worsening left foot rest pain.
Read MoreMisdiagnosed 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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