A Non-Atherogenic Cause of Critical Limb Ischemia in a Young Adult

Aim: Atherosclerosis is the most common etiology of obstruction of the arteries leading to limb ischemia. Critical limb ischemia (CLI) in a young adult we need to consider non-atherosclerotic diseases.

Case Presentation: We present a rare of cause CLI in a 35-year-old man who presented with Rutherford class VI symptoms of non-healing gangrenous right great toe. His angiograms revealed medial type of fibromuscular dysplasia (FMD) and underwent endovascular therapy. Multiple interventions with balloon angioplasty, laser atherectomy and Ultrasound-accelerated catheter-directed thrombolysis in three different settings were needed to achieve desired results.

Discussion and Conclusion: In most cases of FMD balloon angioplasty itself is sufficient. But below knee arteries might need more than one intervention as noted in this case.