Case Study: Successful Revascularization in Critical Limb Ischemia

Let’s dive into the details….

• Patient Profile:

  Age: 67-year-old male

• Medical History: Type II diabetes mellitus, diabetic neuropathy, dyslipidemia, bilateral lower limb arterial occlusive disease, and hypertension
• Symptoms: Bilateral lower extremity pain (more severe on the left side) and a medium-sized plantar ulcer on the left forefoot
• Renal Function: Moderately reduced with an estimated glomerular filtration rate of 25 mL/min/m2

• Diagnostic Process:

  To assess the extent of peripheral vascular disease and develop an effective treatment plan, we conducted a lower extremity MRA study.

• Diagnostic Findings:

  Left Leg: The left posterior tibial artery was occluded, while the anterior tibial artery showed short segment occlusion in the proximal calf with reconstitution in the mid-calf and dorsalis pedis patency.

  Right Leg: Mild multifocal outflow disease involving the superficial femoral and popliteal arteries, with a two-vessel run-off to the foot via a mildly diseased peroneal artery and a severely diseased anterior tibial artery with dorsalis pedis patency.

• Treatment Approach:

  We proceeded with a strategic revascularization plan tailored to the patient’s condition. Using a combination of atherectomy and balloon angioplasty, we successfully revascularized the left posterior tibial artery. Within a remarkable three weeks, we saw rapid wound healing and significant symptomatic improvement. The patient experienced relief from lower extremity pain, and the plantar ulcer demonstrated promising healing progress.

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