85 year old male.
T2DM – 35 years duration
R/ forefoot amputation – non-healing post op (2017)
H/O angioplasty and bypass (fem pop) R/leg (2017)
Ulcer apex left 1st
Non-palpable foot pulses
Severe peripheral arterial disease requiring further vascular assessment and referral to vascular services for assessment within a maximum two weeks.
Having the peroneal assessed here would be helpful in determining the vascular choices for this person. This type of person is who you would want to know about the peroneal because you’re looking for re-vascularisation options. There’s a chance the peroneal might be the best/ better artery. If you are reviewing these patients you want to hear if all three arteries are audible as you may need a comparator if surgery is not an option. You will want to know whether one ‘dies’ off or whether peroneal should be part of the package in this person.
From experience the opinion is inexperience individuals may think they are hearing biphasic pulse sounds here but this patient requires further assessment, particularly to see if his bypass is still working.