80 year old gentleman presents with slowly healing R foot 2nd toe ulcer (Rutherford Grade III – Category V, Fontaine stage IV, Wifi 1, 2, 1). His past medical history includes uncontrolled hypertension, Paroxysmal atrial fibrillation, Coronary Artery Disease s/p PCI to LAD in 2012, PAD s/p RSFA stenting at outside hospital 2 years ago. His medications include Aspirin, Eliquis, Metoprolol, Zocor and Lisinopril. He underwent ABI that was 0.35 in right lower extremity and 0.8 in left lower extremity. US Duplex showed severe in-stent stenosis of RSFA with distal occlusions and occluded AT. He underwent diagnostic peripheral angiogram at outside hospital that showed occluded RSFA stents with stent fracture with one vessel runoff. Here for Angioplasty of RSFA ISR.
Management of Aortoiliac Disease (CERAB Technique) – September 2020
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 […]
LEFT SFA CTO REVASCULARIZATION – August 2020
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.
Transradial Approach for CFA Intervention Involving Fem-Fem Bypass Graft – July 2020
Case and Plan: 70 year-old male with a PMHx of HTN, HLD, asthma, NIDDM, CKD Stage III, HFpEF (55%), MGUS, CAD s/p 2vCABG and PAD s/p bilateral common iliac stent c/b left common iliac artery stent occlusion s/p R->L fem-fem bypass who is presenting with progressive claudication now present at rest (Rutherford 4). Lower extremity […]
Chronic total occlusion (CTO) of left popliteal artery – June 2020
Case and Plan: This is a 68 F with hypertension, diabetes, dyslipidemia and peripheral arterial disease who had prior interventions of the right lower extremity. She presented to the office with life style limiting claudication that has progressed to pain at rest despite optimal medical and exercise therapy. Non invasive studies showed severely reduced ABI […]