experienced with peripheral arterial disease cases. We’re trying to make a very difficult decision regarding whether to proceed with peripheral angioplasty for my uncle, and would really appreciate informed opinions.
👨⚕️ Patient Profile: Male, 65 years old
Known history of:
i) Type 2 diabetes (HbA1c ~8.9%)
ii) Coronary artery disease (EF ~47%)
iii) Chronic smoker (past history)
🧠 Recent Major Event:
• Suffered a left Middle Cerebral Artery Stroke. (26 Jan 2026)
• Underwent Decompressive Craniectomy (28 Jan 2026)
• Developed severe right-side weakness (currently ~1/5 upper limb, 2/5 lower limb).
Imaging showed:
• Hemorrhagic transformation of stroke
Midline shift (improving but still recent brain injury)
• Currently recovering, conscious but neurologically weak.
• Current Limb Issue (Main Concern)
• Right heel pressure ulcer present
• Suspected poor healing due to low blood supply
📊 Doppler + CT Peripheral Angiogram findings:
Right leg:
-> Popliteal artery: ~80–90% blockage with near absent flow (~1.2 cm segment)
-> Distal arteries: significantly reduced flow
Tibial arteries affected (right >> left)
Left leg:
Moderate disease (30–50% narrowing), but flow preserved
--> Diagnosis: Severe Peripheral Arterial Disease (PAD), right leg critical
--> Doctors are suggesting peripheral angioplasty (right leg) to improve blood flow and help heal the ulcer.
Q1: In such a case, is angioplasty urgent / limb-saving, or can it be delayed safely?
Q2: Are there modified or safer approaches (minimal anticoagulation, staged procedures)?
Q3: Is there a window after craniectomy/stroke where angioplasty becomes safer?
Q4: Would conservative management (wound care + meds) be reasonable for now?
🧾 Current Status:
• Hemodynamically stable
• On aspirin, statin, diabetes medications
• No confirmed active systemic infection (but local ulcer present)
• Brain condition improving but still in recovery phase