title: An uncommon clinical presentation of acute limb ischemia: underscoring the role of perigenicular collaterals.
abstract: We present a case of atypical acute limb ischemia in a non-diabetic patient, with ankle-brachial pressure index of 0.6 and rest pain localized exclusively over the gastrocnemius muscle, sparing the foot. This uncommon presentation was attributed to an impaired perigenicular collateral network. Thrombolysis restored adequate perfusion only temporarily and was followed by thromboembolectomy. The ischemia presentation in our case underscores the importance of the adequacy of the perigeniculate collateral network for the perfusion of the tibial muscles and, especially, the gastrocnemius muscle.
authors.affiliation: Department of Vascular Surgery, Demokritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece. efstratiosgeorge@gmail.com
authors.forename: Efstratios
authors.initials: E
authors.lastname: Georgakarakos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kapoulas
authors.forename: Dimitris
authors.initials: D
authors.lastname: Koukoumtzis
authors.forename: Michalis
authors.initials: M
authors.lastname: Mantatzis
authors.forename: Miltos K
authors.initials: MK
authors.lastname: Lazarides
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D003097:Collateral Circulation; D017128:Embolectomy; D004617:Embolism / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D007866:Leg / Q000098:blood supply*; D008297:Male; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000473:pathology