Real Patient Story: How Angioplasty Saved a 68-Year-Old's Leg from Diabetic Gangrene

This is a representative story of the type of cases seen at Medanta Lucknow — compiled to illustrate how limb-salvage angioplasty works in practice. Patient details have been anonymised.

The Patient

Mr. S.K., a 68-year-old retired government employee from Lucknow, presented to Medanta Hospital with blackening of the second and third toes of his right foot. He had Type 2 diabetes for 22 years and had been a smoker for 30 years (quit 5 years ago). He had noticed the toes darkening over the past 3 weeks but attributed it to bruising. His wife finally insisted he seek medical attention when the toes turned completely black and the foot began to smell.

Initial Assessment

On examination, Dr. Rohit Agarwal found absent foot pulses, an ABI of 0.35 (severely reduced), and dry gangrene of toes 2 and 3 with the line of demarcation just below the metatarsal heads. CT Angiography revealed a complete occlusion of the superficial femoral artery (mid-thigh) and severe narrowing of the below-knee tibial arteries.

The Procedure

Within 24 hours of presentation, Mr. S.K. underwent peripheral angioplasty. Under local anaesthesia, access was obtained through the left femoral artery (opposite leg, to approach the blockage from above). The 18 cm femoral artery occlusion was crossed using subintimal angioplasty technique. A drug-coated balloon was used to open the tibial arteries supplying the foot. By the end of the procedure, a completion angiogram showed robust flow all the way to the foot. Mr. S.K. reported his foot feeling warm for the first time in months.

Recovery

Mr. S.K. was discharged the following morning on antiplatelet medications. Over the next 6 weeks, the gangrenous toes demarcated and separated naturally, requiring only minor wound care. No surgical amputation was needed. At 3 months, a Doppler scan confirmed the arteries remained open. Mr. S.K. returned to his morning walks — something he had not been able to do for over a year.

The Lesson

Mr. S.K. was told by two other hospitals that amputation was inevitable. At Medanta Lucknow, vascular assessment and angioplasty gave him his foot back. This is the reality of what interventional radiology gangrene treatment in Lucknow can achieve when patients come in time.