History of Presenting Illness
Our patient is an 80-year-old female with peripheral arterial disease presenting for a staged intervention of the left anterior tibial artery.
• Lifestyle-limiting claudication with progression to ischemic rest pain
• Non-healing left lower extremity arterial ulcer. CLIwith Rutherford category 5 PMHx: Hypertension, Insulin dependent diabetes mellitus, PAD with multiple prior peripheral interventions, most recently Atherectomy + ballon angioplasty of the left posterior tibial artery, unsuccessful antegrade LATA CTO attempt Social Hx: Former Smoker Medications: Aspirin, Plavix, Atorvastatin, Losartan, Metformin, Insulin
Chronic Limb Threatening Ischemia
• Ischemic rest pain, ulcerations or gangrene.
• Treatment includes guideline-directed medical therapy to reduce cardiovascular risk, revascularization to improve limb perfusion, and local care to control infection and improve wound healing.
• Without timely revascularization, the incidence of limb amputation is approximately 25% at 1 year after diagnosis.
• Surgical bypass and endovascular therapy are the principal revascularization strategies used to treat CLTI
