Peripheral cases
Endovascular Intervention of CTO of Left Common Iliac and Distal Aortic/Common Iliac Bifurcation – April 2014

An 80-year-old female patient with a past medical history of hypertension, dyslipidemia, asthma, coronary artery disease status/post CABG presents with complaints of bilateral claudication in buttocks, hip and calf with left > right leg (Rutherford class I, category 3). Patient had ABI/PVR which showed 0.72 on the right and 0.44 on the left with waveforms suggestive of aortoiliac disease. Peripheral angiogram performed showed significant stenosis of the distal aorta, ostial right common iliac artery stenosis and chronic total occlusion (CTO) of the left common iliac with reconstitution at the proximal left external iliac (Image A). Borderline stenosis of the left superficial femoral artery and right posterior tibial artery were also noted. Patient currently planned for an endovascular intervention of the CTO of the left common iliac and distal aortic/common iliac bifurcation. We will discuss the endovascular indications, the approach towards complex iliac lesions and the TASC C/D lesions.

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Suggestions
Transradial Intervention of Iliac Disease for Chronic Limb Ischemia – November 2020
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Case and Plan: Patient is a 54-year-old female smoker with known PAD, s/p R fem-pop bypass, s/p unsuccessful PTA of left SFO CTO on 10/2019 who is presenting with non-healing left foot ulcer for 2 months and associated ischemic rest pain (Rutherford grade III, category 5). Planned transradial intervention for L external iliac severe stenosis.


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Case and Plan: 72 year-old female with hypertension, hyperlipidemia, COPD, hypothyroidism, former smoker with several months of bilateral, severe lifestyle limiting claudication with less than 1/2-1 block of exertion that has progressed to pain at rest. Pain involves her bilateral thighs, legs and feet. Noninvasive studies severely reduced ABIs bilaterally with monophasic waveforms in the […]


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Case and Plan: 55 year-old-male with mutliple comorbidities, who presents with ongoing, bilateral lifestyle-limiting claudication now progressed to rest pain (L>R) who is status post R SFA CTO intervention and now planned for L SFA CTO intervention via femoral approach.