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Problem
The 62-year-old male was admitted for treatment of his peripheral artery disease, which was worsening with the increase of claudication and rest pain. The patient had been reluctant to undergo the bypass graft of the chronic occlusion of his left superficial femoral artery found by his physician months ago. Now in addition to the increased pain and coldness of the foot, there is a breakdown of the skin with non-healing ulcerative sores forming on the lower calf has convinced him that it is time for treatment. Using fluoroscopy a femoral angiography with low contrast was first performed to confirm the exact location of the occlusion and to establish the optimal placement of the bypass graft to re-vascularize the leg and foot. The patient was taken to the operating room where an open femoral-tibial bypass graft with Dacron synthetic material was performed with excellent response. The patient's left lower extremity pulses were stronger and his left foot was warming. He was doing so well he was discharged home after just 5 days. With the atherosclerotic plaquing prevalent throughout the rest of the artery, further workup will be done to determine the extent to come.
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