Sep 7th 2020

Critical Limb Ischemia

A 58- year old male with insulin dependent diabetes, hypertension, dyslipidemia, glaucoma, benign prostatic hyperplasia, gastroesophageal reflux disease, end stage renal disease, s/p kidney transplant, with bilateral PAD/CLI L>R. He underwent angioplasty of left PT, AT, but hallux gangrene progressed to forefoot gangrene with worsening rest pain. Patient underwent non-invasive diagnostic testing and angiograms; pedal loop recanalization was attempted without success. Percutaneous DVA was preformed with venous duplex showing no DVT. Procedure was deemed successful and patient was discharged after 4th day of hospital stay. Follow up care showed no rest pain with well demarcated gangrene and patent stent grafts.