Case and Plan:
History of Presenting Illness:
54 year old male with bilateral (L >> R) lower extremity claudication that has progressed to ischemic rest pain despite optimal medical therapy as well as slow-healing 1st digit gangrenous ulcer (Rutherford III, 5; WiFi clinical stage 4 with high 1 year risk of amputation and high likelihood of benefit for revascularization)
PMHx:
Primary HTN, CAD s/p PCI, ESRD s/p right renal transplant, Hypercholesterolemia, Type II DM, Chronic Venous Insufficiency s/p ablations, Chronic Systolic HF
Social HX: Former Smoker
Medications:
Aspirin, Clopidogrel, Carvedilol, Bactrim, Envarsus, Nifedipine, Atorvastatin, Empagliflozin, Repaglinide, Sacubitril/Valsartan
