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.
Management of SFA In-Stent Restenosis – February 2021
Case and Plan: 62-year-old female with history of PAD s/p prior peripheral interventions presenting with severe right calf pain with minimal ambulation (
Transpedal Approach for SFA CTO Intervention – January 2021
Case and Plan: 77 year-old-female with a PMHx of HTN, HLD, CAD s/p PCI (last being in 2010), AAA s/p endovascular repair 11/2019, hypothyroidism, who presented originally in 7/2020 with worsening debilitating claudication bilaterally, L to R, despite maximal medical therapy, limited to 1 block (Rutherford Grade II, Category 3). After successful revascularization of L […]
Endovascular Management of Aorto-Iliac Disease – December 2020
Case and Plan: 42-year-old male with history of hypertension, type 2 diabetes and hyperlipidemia presenting with lifestyle-limiting lower extremity claudication with minimal exertion, after walking 2 blocks and resolves with rest (Rutherford grade I, category 3). Non-invasive studies suggestive aorto-iliac bifurcation disease with monophasic waveforms below the segment. Patient underwent CT Angio with bilateral iliac […]
Transradial Intervention of Iliac Disease for Chronic Limb Ischemia – November 2020
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.