PMC3437617_01
Photographs of dorsal (a) and plantar (b) ischemic toes of the right foot; the I toe presented an ulceration located at the extremity (arrow). Previous amputation of the III toe is also evident.
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fig1
A 64-year-old man presented to our attention with ischemic signs on the I and II fingers of the right foot and a rounded-shaped ulcer at the top of the I toe (Figure 1).
(a) Volume Rendering reconstruction of CT-A study. On the right side a large abnormal artery originates from a hypertrophic internal iliac artery and run along the gluteal region and the posterior thigh supplying the entire vascular axis of the leg (arrows). ((b)-(c)) The external iliac, the deep femoral and the superficial femoral arteries showed a slightly reduced caliber but no obstruction (arrowheads). (d) The circulation of calf and foot are regularly patent (arrowheads).
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fig2
The distal circulation supplied by the abnormal artery was not compromised: in fact the whole leg vasculature was preserved with normal caliber of anterior tibial, posterior tibial, and peroneal arteries (Figure 2).
(a) Volume rendering reconstruction of CT-A study. On the left side the same abnormal vessel was depicted (arrows); however, it ended with a progressively reduced caliber at the popliteal level with muscular branches (b) (arrowheads). (c) The distal arterial circulation of the calf and foot was supplied by the superficial femoral artery that presented regular caliber and course (arrowheads).
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Similarly, the abnormal artery was depicted also on the left side, presenting the same origin and course (Figure 3).
(a) Maximum intensity projection reconstruction on a coronal plane with bone subtraction technique. No severe signs of atherosclerosis were depicted in the whole peripheral circulation. ((b), (c), (d)) Multiplanar reconstructions on axial plane show, respectively, the course of the sciatic artery (arrows) and that of femoral arteries (arrowheads).
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