A 72-year-old patient presented with a wound on her left foot, initially appearing as a small black spot on a toe tip that later extended to other toes and the instep of the foot (Figure 1). At first, thinking it was a regular inflammation, she took medicine and sought help at a nearby clinic, but the wound persisted. Seeking assistance at the Emergency Department of Walailak University Hospital, she underwent an examination, revealing a suspected blockage in the blood vessel supplying her left leg. After further evaluation by the cardiovascular surgeon, including a CTA of the abdominal aorta, it was discovered that there was an abdominal aortic aneurysm accompanied by a significant blood clot (Figure 2). This blood clot was identified as the root cause of the blockage in the vessel supplying blood to the left leg (Figure 3), ultimately leading to the decision to amputate the left leg due to the presence of extended tissue death.
In response, surgeons planned to treat her by surgically inserting an artificial artery through a catheter to repair the aneurysm along the abdominal aorta (Figure 4). Three days post-surgery, follow-up CTA of the abdominal aorta indicated normal blood flow to the left leg (Figure 4).
Despite the loss of part of her leg, the patient’s successful treatment, involving expert surgical skills and advanced medical technology, allowed for a prosthetic leg replacement from the Prostheses Foundation of HRH the Princess Mother. The patient has since returned to live her normal life. Timely diagnosis and intervention were crucial, as delayed detection could have resulted in further limb loss or death from a ruptured aortic aneurysm.