Patient History: 83-year-old female with PMH of PMH of HTN, HLD, PAD s/p PTAs last on 08/2017 (8.0X60 absolute pro right external iliac artery), CAD with prior MI s/p PCIs (last PCI on 04/2017), Left Carotid Endarterectomy, prior CVA who presents w/ bilateral lower extremity lifestyle limiting claudication L>R; ET < 1 block. (Rutherford Grade 1, Category 3). Patient lost to follow up since end of 2017, seen back on 05/2022 and refused intervention until 08/2022 when she presented to clinic with worsening symptoms. Meds: Aspirin 81mg, Brilinta 60 mg BID, Atorvastatin 80mg, Toprol XL 100 mg QD, HCTZ 25 mg QD, Imdur 60 mg QD, Cilastazol 50 mg BID Exam: Doppler DP pulses bilaterally. Plan: Despite maximal tolerated medical therapy and exercise therapy has persistent lifestyle limiting claudication. Planned for reattempt at endovascular treatment for long segment CTO of left common iliac into common femoral using a radial approach and CTO re-entry device.
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