80 year old female patient with past medical history of hypertension, dyslipidemia, diabetes mellitus type II, 40 pack year smoking history presents with complaints of bilateral claudication in calf with right left leg (Rutherford class I category 3). Patient had ABI/PVR which showed 0.7 on the right and 0.82 on the left with waveforms suggestive of femeropopliteal disease. Peripheral angiogram performed showed chronic total occlusion (CTO) of the ostial right superficial femoral artery (SFA), CTO of the right anterior tibial and posterior tibial artery. Boderline stenosis of the left common iliac artery, significant stenosis of the left superficial femoral artery, left peroneal artery and CTO of the left anterior tibial noted. Patient currently planned for an endovascular intervention of the CTO of ostial right SFA via retrograde approach. We will discuss about the endovascular indications, approach towards complex SFA CTO via retrograde approach.
Prior failed intervention of the Left SFA ISR, Re-attempt via Pedal Access – January 2020
Tags: ISR | Left SAF | Pedal Access
Case and Plan: 67 Male with HTN, DM, HLD and PAD (prior stent of the left SFA), who presented with life style limiting claudication (L>R). Non-invasive workup revealed in-stent re-stenosis of the prior SFA stent. A subsequent attempt to intervention was unsuccessful from the CFA, now referred for a re-attempt to intervention via pedal approach.
Popliteal Artery CTO Intervention w/ failed prior attempt
Tags: CTO | Peripheral | Popliteal Vein Access
Case and Plan: 68 M with Hypertension, hyperlipidemia, smoking and known history of PAD, presents with worsening R > L claudication, that has progressed to pain at rest. He had a subsequent angiogram done that showed complete occlusion of the popliteal artery that reconstitutes at the level of TP trunk. He had a prior attempt […]
Left SFA In-stent Restenosis Intervention – Nov 27
Case and Plan: 68 year-old female with HTN, DM, hyperlipidemia and currently smokes. Presents with BL (L>R), lifestyle limiting claudication (Rutherford 4) that has progressed to pain at rest despite OMT. Noninvasive workup showed an ABI with exercise of (R): 0.95 and 0.89 (L): 0.92 and 0.67 . Subsequent US showed in-stent restenosis of the […]
Left SFA CTO – Oct. 2019
68 year old female with HTN, DM, HLD who presents with life style limiting claudication, that has progressed to pain a rest. She had a non invasive workup done revealing abnormal ABI. She had a subsequent peripheral angiogram done revealing mid Left SFA total occlusion and referred for further intervention.