The patient is a 64-year-old male with a long standing history of peripheral vascular disease who has had multiple vascular procedures in the past including a fem-fem bypass , a left fem pop as well as bilateral TMAs and a right fem pop bypass who presents with a nonhealing wound of his left TMA stump as well as a pretibial ulcer that is down to the bone .
The patient was admitted to obtain adequate pain control and to have an MRI / MRA to evaluate any possible bypass procedures that could be performed .