CLI with Calcified Popliteal CTO with One Vessel Runoff In a Patient with Knee Replacement and Complex Visualization – October 2022

Patient History:
90-year-old male with Sick sinus syndrome s/p PPM, HTN, HLD, early Parkinson’s disease. Presented with non healing ulcer on 2nd and 3rd digit on the left lower ext since July. Pain had progressed to rest pain (Rutherford Grade III Category 5). He is no longer able to tolerate exercise.

Meds:
Amlodipine, atorvastatin, ASA, Plavix, memantine

Plan:
– Right femoral artery access
– Up and over anterograde cross attempt
– Possible pedal access
– Shockwave and possible atherectomy