78- year- old male patient with past medical history of hypertension, dyslipidemia, CAD s/p CABG, CKD stage II, type II DM, CVA, and mild intermittent asthma presented with complaints of left leg pain with non- healing ulcer along the dorsal surface of the foot (Rutherford class III category 5, Fontaine IV). Peripheral angiogram performed showed significant stenosis of mid left superficial femoral artery, CTO of the mid left anterior tibial artery, CTO of the left tibioperoneal trunk, distal reconstitution of the left peroneal artery and left posterior tibial artery via the proximal anterior tibial collaterals, including distal reconstitution of the dorsalis pedis via the peroneal artery collaterals.
Plan: Patient is currently scheduled for endovascular treatment of the CTO of the left tibioperoneal trunk.