Distal Reconstitution in Surgery — 62yo Man | Vascular Surgery | SMLE Q#18772
SMLE Question #18772
Surgery
Vascular Surgery
Objective: OBJ-472
Last updated: March 2026
A 62-year-old man has 2 months of progressive exertional left calf pain relieved by rest. He can walk ~50 meters before pain starts. He has diabetes mellitus and a 40-pack-year smoking history. Symptoms persist despite antiplatelet therapy, high-intensity statin, and a supervised exercise program. Left ankle–brachial index is 0.3. CT angiography shows a focal 3-cm occlusion of the left popliteal artery with distal reconstitution and patent tibial runoff. There is no rest pain, ulceration, or gangrene. What is the most appropriate next step in management?
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