Chief complain- 1-Angina on exertion (NYHA grade II) for 6 months 2-Intermittent claudication (Fontaine stage II) lt lower limb for 6 months 3-Gradual blackening(gangrene) of Lt foot for 2 monthsPast h/o- K/C/O DM Type 2 and essential hypertension for 10 years on irregular treatment in the form of oral tablets.

Nirmala devi 50 years/ Female

Left foot

Non smoker. On examination- General examination- PR-94/min,regular. BP- 150/84 mmHg

Carotid

Brachial

Radial

Femoral

Popliteal

Post tibial

D.Pedis

Left + + + + Diminished

- -

Right + + + + + + +

Peripheral pulses

Systemic examination— Chest- B/L Clear CVS - s1 s2 normal. no murmur.

2D ECHO- No RWMA,LVEF 60% Grade I DD Concentric LVH Rest normal studyColour doppler lower limbs- Lt LL- Diffuse thrombus in proximal and mid SFA (67% stenosis) with obstructed flow in popliteal,distal ATA and DPA. Rt LL-Normal study

Arterial supply of Pelvis

Arterial supply of lower limb

Arterial supply of lower limb

Arterial supply of lower limb

Arterial supply of lower limb

THANKS