72 year old gentleman presents with non-healing L foot dorsal aspect ulcer with claudication at rest (Rutherford Class III – Category V). His past medical history includes Hypertension, Dyslipidemia, Coronary Artery Disease s/p PCI to LAD in 2009, Chronic Kidney disease (Cr 1.9) and Insulin dependent Diabetic Mellitus. His medications include Aspirin, Plavix, Metoprolol, Norvasc, Benicar, Glucophage, Zocor and Insulin. He underwent ABI that was 0.4 in left lower extremity and 0.9 in right lower extremity. US Duplex showed severe stenosis of L Tibio –peroneal trunk (TPT) and multilevel infra-popliteal occlusions. He underwent PTA of L TPT ON 11/25/2015. Now planned for Antegrade/Retrograde approach Percutaneous Transluminal Angioplasty of L AT and L PT (for complete revascularization of pedal arch).
Management of Aortoiliac Disease (CERAB Technique) – September 2020
Case and Plan: 72 year-old female with hypertension, hyperlipidemia, COPD, hypothyroidism, former smoker with several months of bilateral, severe lifestyle limiting claudication with less than 1/2-1 block of exertion that has progressed to pain at rest. Pain involves her bilateral thighs, legs and feet. Noninvasive studies severely reduced ABIs bilaterally with monophasic waveforms in the […]
LEFT SFA CTO REVASCULARIZATION – August 2020
Case and Plan: 55 year-old-male with mutliple comorbidities, who presents with ongoing, bilateral lifestyle-limiting claudication now progressed to rest pain (L>R) who is status post R SFA CTO intervention and now planned for L SFA CTO intervention via femoral approach.
Transradial Approach for CFA Intervention Involving Fem-Fem Bypass Graft – July 2020
Case and Plan: 70 year-old male with a PMHx of HTN, HLD, asthma, NIDDM, CKD Stage III, HFpEF (55%), MGUS, CAD s/p 2vCABG and PAD s/p bilateral common iliac stent c/b left common iliac artery stent occlusion s/p R->L fem-fem bypass who is presenting with progressive claudication now present at rest (Rutherford 4). Lower extremity […]
Chronic total occlusion (CTO) of left popliteal artery – June 2020
Case and Plan: This is a 68 F with hypertension, diabetes, dyslipidemia and peripheral arterial disease who had prior interventions of the right lower extremity. She presented to the office with life style limiting claudication that has progressed to pain at rest despite optimal medical and exercise therapy. Non invasive studies showed severely reduced ABI […]