Mönckeberg’s Disease of the Lower Limb

Vasc Endovascular Surg . 2021 May;55(4):422-423. doi: 10.1177/1538574420987448. Epub 2021 Jan 19.

Fecha de la publicación: 29/01/2021

Autor: Enrique M San Norberto (1), Álvaro Revilla (1), Carlos Vaquero (1)

Palabras clave: Atherosclerosis, Mönckeberg medial calcific sclerosis, Peripheral artery disease, Vascular calcification



1Division of Vascular Surgery, 16238Valladolid University Hospital, Valladolid, Spain.


Vascular calcification represents a group of several pathological states of differing aetiologies. Mönckeberg medial sclerosis is considered to be more widespread in the lower abdominal region and lower limbs. We present a 59-years-old male patient presented right foot gangrene. At physical exploration, femoral and popliteal pulses were presented and the ankle-brachial pressure index was 0.45, and the toe-brachial index was 0.33. The patient underwent distal angioplasty of anterior and posterior tibial arteries and due to inaccurate evolution a transmetatarsal amputation was required. Mönckeberg’s medial sclerosis is diagnosed with an ABI>1.1, however, questions have been raised about the validity and the role of ABI in diagnosis of Mönckeberg’s medial sclerosis. Colour-doppler vascular ultrasound allow a non-invasive technique widely available to detect vascular calcification and to differentiation between Mönckeberg’s medial sclerosis and the atherosclerosis-related lesions.