Case Highlight of the Week: Successful Revascularization for Left Hallux Ulcer

Patient Profile: 75-year-old male with a complex medical history, including systemic hypertension, hyperlipidemia, DM, and atrial fibrillation. He recently presented with a troublesome left hallux ulcer, which had persisted for three weeks, causing considerable discomfort.
Diagnostic Process: Upon examination, we observed diminished distal pulses bilaterally, with pronounced claudication symptoms primarily affecting the left lower extremity. Arterial ultrasound revealed a 50-74% stenosis in the left superficial femoral artery (SFA) and left popliteal artery, alongside monophasic waveforms in more distal arteries on the left side. To confirm these findings, we proceeded with a peripheral angiogram. Leveraging an antegrade approach, we performed a successful balloon angioplasty to address the stenosis in the left SFA and popliteal artery. The outcomes were remarkable, with a significant improvement in blood flow to the distal areas, including the posterior circulation. In fact, we achieved complete revascularization of the distal circulation by utilizing a small balloon in the forefoot.
Treatment Outcome: Just two weeks post-procedure, our patient experienced a remarkable improvement in his claudication symptoms, and the left hallux ulcer demonstrated excellent healing. The collaborative effort between our interventional vascular team and the patient’s primary care team yielded outstanding results, highlighting the efficacy of our approach.

Disclaimer: Patient consent was obtained for case sharing. Identifying details have been modified for privacy.

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