75-year-old female patient with past medical history of hypertension, dyslipidemia, diabetes mellitus type II, and prior MI, came in with complaints of right calf pain on minimal exertion (Rutherford class I category 3, Fontaine IIb) on cilostazol. MRA showed bilateral SFA occlusion with distal reconstitution. Peripheral angiogram performed showed borderline stenosis of the right external iliac artery, severe calcified long segment CTO (chronic total occlusion) of proximal/mid/distal right superficial femoral artery (SFA), distal reconstitution of the proximal right popliteal artery via the profunda collaterals (shown in picture 1, 2, & 3), CTO of the mid right anterior tibial artery with distal reconstitution of the right dorsalis pedis artery via the peroneal artery collaterals, CTO of mid left SFA with distal SFA reconstitution, CTO of the mid left anterior tibial artery with distal reconstitution of the left dorsalis pedis artery via the peroneal artery collaterals. Patient is currently planned for an endovascular intervention of the long segment calcified SFA CTO (TASC D lesion). We will discuss the endovascular indications and approach towards the long segment calcified TASC D SFA lesions.
Management of SFA In-Stent Restenosis – February 2021
Case and Plan: 62-year-old female with history of PAD s/p prior peripheral interventions presenting with severe right calf pain with minimal ambulation (
Transpedal Approach for SFA CTO Intervention – January 2021
Case and Plan: 77 year-old-female with a PMHx of HTN, HLD, CAD s/p PCI (last being in 2010), AAA s/p endovascular repair 11/2019, hypothyroidism, who presented originally in 7/2020 with worsening debilitating claudication bilaterally, L to R, despite maximal medical therapy, limited to 1 block (Rutherford Grade II, Category 3). After successful revascularization of L […]
Endovascular Management of Aorto-Iliac Disease – December 2020
Case and Plan: 42-year-old male with history of hypertension, type 2 diabetes and hyperlipidemia presenting with lifestyle-limiting lower extremity claudication with minimal exertion, after walking 2 blocks and resolves with rest (Rutherford grade I, category 3). Non-invasive studies suggestive aorto-iliac bifurcation disease with monophasic waveforms below the segment. Patient underwent CT Angio with bilateral iliac […]
Transradial Intervention of Iliac Disease for Chronic Limb Ischemia – November 2020
Case and Plan: Patient is a 54-year-old female smoker with known PAD, s/p R fem-pop bypass, s/p unsuccessful PTA of left SFO CTO on 10/2019 who is presenting with non-healing left foot ulcer for 2 months and associated ischemic rest pain (Rutherford grade III, category 5). Planned transradial intervention for L external iliac severe stenosis.