case_images: PMC10313132_01
case_images: Physical examination of the wound, preoperative CTA examination of lower limb vessels, and angiography after lower limb arterial reconstruction. It was a round ulcer of approximately 5 cm x 5 cm in diameter, which was covered with large black scabs, and the tissue around it was cool, dark red, and swollen (A). Long segment occlusion of the inferior segment of the right superficial femoral artery with segmentary severe stenosis (B). The vascular lumen of the superficial femoral artery, popliteal artery, anterior tibial artery, peroneal artery, and some arterial arches of the foot were unobstructed in the affected limb after lower limb arterial reconstruction (C). CTA, computed tomography angiography.
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case_images: The tissue around it was cool, dark red, and swollen (Figure 1A). Computed tomography angiography (CTA) examination further indicated mild-to-severe stenosis in multiple segments of her bilateral femoral and popliteal arteries, as well as complete occlusion of her right femoral artery and posterior tibial artery (Figure 1B). Preoperative angiography confirmed long segment occlusion of the inferior segment of her right superficial femoral artery with segmentary severe stenosis (Figure 1B). Postoperative angiography showed that the vascular lumen of the superficial femoral artery, popliteal artery, anterior tibial artery, peroneal artery, and some arterial arches of the foot were unobstructed in the affected limb (Figure 1C).
case_images: The repair of the wound and postoperative follow-up. After the blood supply improved, the wound repair procedure began. Wound debridement began approximately 4 weeks after the vascular intervention, with fresh granulation tissue hyperplasia at the base of the wound and bleeding after scraping (A). The location of perforating artery of peroneal artery perforator flap (B). Peroneal artery perforator flap design during operation (C, D). The wound condition after the operation (E) and dressing change of the wound post-operation (F). At the postoperative follow-up, the patient's wound healed completely approximately 7 weeks after the operation (G).
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case_images: PMC10313132_01_fendo-14-1198818-g002.jpg
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case_images: In the 7th week, stitches were removed, and the flap was alive (Figure 2G).