Bilateral external Iliac and femoral thromboses. Renal cortical infarcts with potential glomerular nephritis. Assessment for proteinuria is recommended. Recommend assessment for hypercoagulable state in this patient. Plavix, plus or minus heparin therapy would be indicated. Interventional radiologist or surgeon may be the best option to address the thromboses. These appear to be relatively well-organized thromboses and therefore have likely been building up in situ for some time. Full coagulation panel with D-dimers, FDP and AT III levels would be recommended. If antithrombotic therapy is to be utilized, recheck sonogram is recommended in 7 to 10 days as patient is at risk for sudden death owing to pulmonary thromboembolic or myocardial thromboembolic events. Blood pressure measurements, assessment for proteinuria, and assessment for tick borne disease are all warranted.