Successful Revascularization of Infra-Popliteal Chronic Total Occlusion (CTO) in a Pt. with Critical Limb Ischemia
- Patient Profile: 72-year-old male, hypertension, dyslipidemia, stable coronary artery disease, peripheral arterial disease, and chronic venous insufficiency. Chief Complaint of non-healing chronic ulcer on the dorsum of the right foot persisting for 3 months, Moderate to severe claudication affecting the right lower limb with progressive worsening, including pain at rest.
- Clinical Presentation: Upon examination, a well-demarcated 2 cm erythematous non-healing necrotic ulcer was observed on the dorsum of the right foot. Peripheral pulses were absent in the right lower limb.
- Diagnostic Findings: (ABI) in the right lower extremity was measured at 0.45, while the left exhibited a value of 0.95. Arterial ultrasound of the right lower extremity revealed monophasic waveforms in the anterior tibial artery (ATA) and a chronic total occlusion (CTO) of the distal tibioperoneal trunk. These findings were confirmed with diagnostic peripheral angiography.
- Treatment Approach: To restore blood flow and alleviate critical limb ischemia, the patient underwent an atherectomy and balloon angioplasty of the right tibioperoneal trunk.
- Patient Outcome: The post-procedure results were successful, with an excellent angiographic outcome. During the four-week follow-up visit after discharge, the patient exhibited significant improvement in symptoms, and a remarkable healing process was observed in the dorsal foot ulcer.
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