Percutaneous transluminal angioplasty for the treatment of ultra focal ischemia-related refractory chronic leg ulcer

Abstract

We describe a case of a focal leg ulcer refractory to conservative therapy. Angiography showed good straight-line flow of the posterior tibial artery and the peroneal artery but pre-occlusive high-grade stenosis of the middle and distal parts of the anterior tibial artery (ATA). Because the stenosis of the ATA was considered a culprit lesion for this focal ulcer, we performed a balloon angioplasty of the ATA, and satisfactory wound healing was achieved 4 months after procedure. In this case, ultra focal ischemia may develop in the anterior compartment of the leg due to impaired flow of the ATA, even in the absence of lesions in the infrapopliteal arteries other than the ATA including a patent pedal arch.

Keywords

• Refractory leg ulcer
• Chronic limb threatening ischemia
• Tibial artery
• Angioplasty
• Angiosome