PMC10267874_01
The physical findings of the left foot during the treatment course. (Panel A) Shows the photo on day 1. After commencing medical treatment, the pain persisted in the left toes and forefoot. (Panels B,C) Presents the skin color change on day 2 and 3. There was progressive cyanosis and impending gangrene change, as shown in (Panel D,E) by day 4. (Panel F) Shows the photo one week after the successful endovascular revascularization. The pain was relieved, and the gangrene was limited to the toe tip.
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F1
It was pale and cold on the left dorsal foot, with minimal pulsation over the dorsalis pedis artery (Figure 1).
The angiography findings before and after endovascular revascularization. The left panel shows that the left anterior tibial artery flow was significantly slowed, and the flow in the posterior tibial artery did not reach the metatarsal arteries. The pedal arch was occluded. After endovascular revascularization, the flow into the anterior tibial artery and pedal arch improved.
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F2
The flow from the origin of the anterior tibial to dorsalis pedis arteries was prolonged and sluggish (Figure 2). The flow to distal metatarsal arteries improved significantly (Figure 2).
The Penumbra ACE 3Max aspiration catheter can be advanced into the left dorsalis pedis artery and pedal arch during aspiration thrombectomy (arrow). Small clots were retrieved.
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F3
Alameda, California, USA) into the left dorsalis pedis artery while keeping continuous aspiration by Penumbra pump. After 90 s, the aspiration catheter was slowly retrieved while maintaining negative aspiration pressure (Figure 3).
The treatment course and timeline during hospitalization.
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F4
The treatment course and timeline can be seen in Figure 4.