Case and Plan:
60-year-old gentleman with past medical history of HTN, HLD, T2DM, CAD s/p PCI, HFrEF LVEF 35%, and PAD with multiple PVIs presents for ongoing poor wound healing of his right foot wound. The patient required deep venous arterialization of his left lower extremity due to prior nonhealing wounds with successful healing after toe amputation.
Now, he has poor wound healing of his right toe and has undergone prior PVI to the R PT without improvement of wound with ongoing severe pain. Venous mapping was performed which did not show adequate size veins for bypass.
He presents for deep venous arterialization of his right lower extremity due to nonhealing, progressing right foot wound. Bypass was believed not appropriate due to medical comorbidities and no adequate veins for bypass.
