Long-standing Type 2 Diabetes in Surgery — 68yo Man | Vascular Surgery | SMLE Q#1111
SMLE Question #1111
Surgery
Vascular Surgery
Last updated: February 2026
A 68-year-old man with long-standing type 2 diabetes mellitus and hypertension has 6 months of progressive right calf pain with walking that improves with rest. Over the last 2 weeks, he reports worsening right foot discomfort and a marked reduction in walking distance. Examination shows a cool right foot, delayed capillary refill, and weaker distal pulses than the left. Which finding most strongly supports chronic critical limb-threatening ischemia rather than acute limb ischemia?
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