Peroneal artery entrapment syndrome (PRAES): a rare cause of ischaemic toes

BMJ Case Rep. 2019 Jan 28;12(1):bcr-2018-227353. doi: 10.1136/bcr-2018-227353.

Abstract

A 75-year-old man presenting with intermittent discolouration of his left toes was referred to vascular surgery with suspicion of embolic vascular disease. A contrast-enhanced MR angiogram was performed which revealed bilateral dominant peroneal arteries (PRAs). There was evidence of short atherosclerotic stenosis directly at the point where the left PRA passes through the tibiofibular interosseous membrane which we postulate to be the source of the emboli. We present what is believed to be the first reported case of PRA entrapment complicated by distal toe emboli.

Keywords: radiology; vascular surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Atherosclerosis / complications*
  • Atherosclerosis / diagnostic imaging
  • Atherosclerosis / drug therapy
  • Clopidogrel / therapeutic use
  • Constriction, Pathologic
  • Diagnosis, Differential
  • Embolism / complications*
  • Embolism / diagnostic imaging
  • Embolism / drug therapy
  • Humans
  • Leg / blood supply
  • Magnetic Resonance Angiography / methods
  • Male
  • Peripheral Vascular Diseases / complications*
  • Peripheral Vascular Diseases / diagnostic imaging
  • Peripheral Vascular Diseases / drug therapy
  • Platelet Aggregation Inhibitors / therapeutic use
  • Syndrome
  • Tibial Arteries / diagnostic imaging*
  • Toes

Substances

  • Platelet Aggregation Inhibitors
  • Clopidogrel