Vascular Surgery

Peripheral vascular disease, aortic aneurysm, and acute limb ischaemia management

Mahesh Pillai — right ankle ABI 0.42 (critical ischaemia). Urgent angiography and revascularisation planning required.
Patient: Mahesh Pillai, 68M
UHID: UH-2026-0816
Diagnosis: Critical limb ischaemia (CLI) — right lower limb
Admission: 22 Jun 2026
Risk Factors: T2DM, HTN, Ex-smoker 40 pack-years, dyslipidaemia
Fontaine Stage: IV (rest pain + toe gangrene)

Vascular Examination

ParameterRightLeft
Femoral PulsePresentPresent
Popliteal PulseAbsentPresent
Dorsalis PedisAbsentPresent
Posterior TibialAbsentPresent
ABI (Ankle Brachial Index)0.42 (Critical)0.92 (Normal)
TBI (Toe)0.18 (Critical)0.64 (Normal)
SkinPallor, mottled, 1st + 2nd toe dry gangreneNormal
Venous filling time> 30 seconds8 seconds
Limb Status:
Threatened

Management Plan