Complex BTK CTO Intervention with Orbital Atherectomy – November 2023

Case and Plan
81 year-old male referred for bilateral lifestyle-limiting claudication progressive to ischemic rest pain (L>R) with < 1 block of activity (Rutherford Grade II, Category 4). PMHx: CAD s/p PCI mRCA (2016), PAD s/p left EIA stent (2020), HTN, HLD, NIDDMII Social Hx: Active smoker Medications: ASA, Plavix, Metformin, Sitagliptan, Rosuvastatin, Toprol XL Access: - Right CFA access with 6F Destination long sheath - Left pedal access (+/-) Adjunctive Therapy: - Orbital atherectomy with Diamondback 360 OAD - (+/-) atherotomy Destination Therapy: - PTA +/- stent (bailout)


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