1. Arterial disease: atherosclerosis, worse in the posterior tibial artery

• There is diffuse plaque and calcification in the leg arteries.
• The left posterior tibial artery has the most notable narrowing with reduced flow velocity in its proximal and mid portions.
• The remaining scanned arteries have preserved triphasic flow, which is reassuring.
• The report does not show a complete arterial blockage. However, its wording is slightly inconsistent: it notes “significant luminal narrowing” but later says no obvious stenosis. The actual Doppler velocity table, ABI, and toe pressures would clarify the severity.

2. Venous disease: mild superficial venous reflux / varicose veins

• The great saphenous vein is mildly dilated, with Grade I reflux at the saphenofemoral junction.
• There are incompetent perforator veins and multiple dilated superficial veins around the lower medial leg, ankle, and foot.
• These findings can contribute to ankle swelling, heaviness, aching, skin discoloration, and eventual ulcers. Venous reflux is a common driver of chronic venous insufficiency, which may cause varicose veins and edema. Schwartz’s Principles of Surgery, 11th ed., section “Chronic Venous Insufficiency.”
• Thickening/calcified plaques in the great saphenous vein may represent old superficial venous inflammation or old thrombosis, not an acute clot.

Reassuring finding

• No deep-vein thrombosis (DVT) and no deep venous reflux were seen. This is important and reassuring.

Swelling and possible cellulitis need prompt attention

Suggested next steps

1. See a vascular surgeon or vascular-medicine specialist soon, preferably within days, especially if there is a wound, rest pain, diabetes, or poor walking distance.
2. Ask for:
   • ABI in both legs, plus toe pressures/TBI if vessels are calcified
   • Pulse examination and foot/wound assessment
   • Review of the arterial Doppler images and velocity measurements
   • Assessment whether CTA/MRA is necessary, particularly if revascularization is being considered.
3. Address vascular risks with the treating doctor:
   • Check and control diabetes, blood pressure, cholesterol, kidney function
   • Stop tobacco in any form
   • Discuss statin and antiplatelet treatment if PAD is confirmed and there is no contraindication
   • Structured walking/exercise only if there is no active infection, foot ulcer, or severe ischemic pain. Risk-factor treatment and ABI-based assessment are emphasized by the ACC PAD care summary.
4. Do not start strong compression stockings/bandaging without ABI or vascular advice, because significant arterial narrowing can make high compression unsafe. If arterial circulation is adequate, compression, leg elevation, skin care, and possibly later treatment of refluxing veins/perforators may help venous swelling.
5. If cellulitis is clinically present, it may require antibiotics and careful foot/skin care prescribed by a clinician.

Seek urgent or emergency care today if any of these occur

• Fever, rapidly spreading redness/warmth, pus, severe tenderness, or confusion
• New black/blue toes, a cold pale foot, sudden severe foot pain, numbness, or inability to move toes
• Non-healing ulcer, especially if painful or with discharge
• Sudden major increase in leg swelling, chest pain, or shortness of breath