A Non-Atherogenic Cause of Critical Limb Ischemia in a Young Adult
Jagadeesh K. Kalavakunta *
Department of Cardiology, Borgess Medical Center, Kalamazoo, MI, USA and Department of Medicine/Pediatrics, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
Yashwant Agrawal
Department of Medicine/Pediatrics, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA
Elizabeth Sayers
Department of Internal Medicine/Cardiology, Metro Health- University of Michigan Health, Wyoming, MI, USA
Fadi Saab
Department of Internal Medicine/Cardiology, Metro Health- University of Michigan Health, Wyoming, MI, USA
J. A. Mustapha
Department of Internal Medicine/Cardiology, Metro Health- University of Michigan Health, Wyoming, MI, USA
*Author to whom correspondence should be addressed.
Abstract
Aim: Atherosclerosis is the most common etiology of obstruction of the arteries leading to limb ischemia. Critical limb ischemia (CLI) in a young adult we need to consider non-atherosclerotic diseases.
Case Presentation: We present a rare of cause CLI in a 35-year-old man who presented with Rutherford class VI symptoms of non-healing gangrenous right great toe. His angiograms revealed medial type of fibromuscular dysplasia (FMD) and underwent endovascular therapy. Multiple interventions with balloon angioplasty, laser atherectomy and Ultrasound-accelerated catheter-directed thrombolysis in three different settings were needed to achieve desired results.
Discussion and Conclusion: In most cases of FMD balloon angioplasty itself is sufficient. But below knee arteries might need more than one intervention as noted in this case.
Keywords: Fibromuscular dysplasia, lower extremity, young adult