Peripheral Arterial Disease

A 72-year-old woman with diabetes, hypertension, and chronic kidney disease (eGFR 35 mL/min/1.73 m²) presents with acute onset of severe pain and coldness in the left foot over the past 6 hours. On examination, the left foot is pale, pulseless, and numb. Femoral pulses are present bilaterally. CT angiography of the lower limbs shows an acute occlusion of the left popliteal artery with no visible thrombus. What is the most likely diagnosis?

A 68-year-old man with a 40-year smoking history presents with a 3-month history of progressive claudication in the right lower limb. Duplex ultrasound reveals a 70% stenosis of the right superficial femoral artery (SFA). He is asymptomatic at rest and can walk 200 meters before claudication. His ankle-brachial index (ABI) is 0.65 on the right. What is the most appropriate initial management?

A 68-year-old woman with diabetes and hypertension presents with acute onset of severe pain in the right foot, which is now pale, pulseless, and cold. She reports sudden onset 4 hours ago while at rest. Examination reveals mottled skin, absent sensory response in the foot, and no femoral, popliteal, or pedal pulses on the right. Contralateral pulses are normal. Blood pressure is 145/92 mmHg, heart rate 98 bpm. What is the most appropriate immediate management?

A 68-year-old man with a 40-year smoking history and poorly controlled diabetes (HbA1c 9.2%) presents with a 3-month history of progressive pain in his right calf during walking that resolves after 10–15 minutes of rest. On examination, the right foot is cool to touch, femoral pulses are palpable bilaterally, but right popliteal and pedal pulses are absent. Ankle-brachial index (ABI) on the right is 0.62. Which of the following is the most appropriate next step in management?

A 72-year-old man with hypertension and hyperlipidemia presents with sudden onset of severe pain in the left leg, pallor, pulselessness, and coldness. On examination, the left foot is mottled and cyanotic; femoral pulse is absent on the left. Right femoral pulse is palpable. He denies recent trauma. Doppler ultrasound shows no flow in the left superficial femoral artery. What is the most likely diagnosis?