Abstract
Objective: Arthrosclerosis results in poor distal limbs perfusion and smoking is a well known risk factor that is associated with formation of arthroma affecting the blood vessel walls. We present here a case involving recurrent attacks of blue toes and intermittent claudication that occurred 2 years after femoro-popliteal bypass surgery. Case Report: The patient was an 88 years old, male who was suffering from blue toes and intermittent claudication. He had undergone bilateral femoro-politeal bypass surgery, but had continued to smoke after surgery. Clinical data obtained by MRA and ABI revealed that there significant worsening of the patient's distal perfusion and that the efficiency of the bypass had decreased measurably. Conclusion: In this case, we want to emphasize on that, even though medication and/or surgery intervention is able to improve ischemic limbs blood perfusion to some degree, if the patient continues to smoke, then the efficiency of the surgery and of any medication declines.
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