For patients with peripheral arterial disease, the mainstay of initial treatment is always risk factor modification, ambulation, and compliance with guideline-based medical therapies. However, for patients who have lifestyle limiting claudication or have progressed to critical limb ischemia (CLI), intervention is warranted.

The patient was a 77-year old diabetic with an ulcer on her big toe. There was almost no blood flow to the foot, and she was in terrible pain. Her podiatrist had sent her to the hospital. The nurses who initially checked the foot had seen cases like this plenty of times. If the woman was lucky, the surgeon might be able to amputate the foot and save the rest of the leg below the knee.