Acute limb ischemia in a morbidly obese diabetic patient with obstructive sleep apnea

Obstructive sleep apnea (OSA) is a common disorder with well-established cardiovascular associations, yet its link to acute limb ischemia (ALI) is rarely described. We report the case of a man in his 50s with morbid obesity having a history of OSA and diabetes mellitus who presented with sudden right leg pain, numbness, and pallor. Clinical evaluation and imaging confirmed ALI, prompting urgent transfemoral embolectomy under general anesthesia, which successfully restored limb perfusion. Laboratory workup revealed elevated hemoglobin (18 g/dL), and his history of chronic intermittent hypoxia suggested a prothrombotic milieu associated with untreated OSA. This case highlights ALI as a potential, although uncommon, thrombotic complication of OSA and underscores the importance of early recognition and intervention in high-risk patients.