Authors: Veronica Galizia , Eniko Nemes-Nagy , Zoltan Preg

Abstract

Background: The purpose of this article is to highlight the importance of in a case of peripheral arterial disease (PAD) with suspected microembolization, through the presentation of a complex clinical case involving a patient with a mechanical heart valve, anemia, and heart failure. The aim is also that of emphasizing the importance of the multidisciplinary approach to treating comorbid conditions, such as type 2 diabetes, in patients with PAD.

Case Presentation: A 48-year-old diabetic and hypertensive man presented with rest pain and left forefoot gangrene. He was diagnosed with advanced PAD (Fontaine stage IV) with multiple comorbidities. Endovascular revascularization and optimized multidisciplinary management were performed, resulting in clinical improvement, increased walking distance, and regression to Fontaine stage IIA.

Conclusion: This case emphasizes that advanced PAD requires prompt multidisciplinary management and strict control of comorbidities, highlighting also that poor adherence to anticoagulation therapy and risk factor management may contribute to complications such as microembolization, which was considered the most likely underlying mechanism in this case, whereas active patient engagement is essential to optimize outcomes and prevent disease progression.

Keywords: Case report, diabetes mellitus, multidisciplinary approach, peripheral arterial disease, quality of life.