Case and Plan:
63-year-old female with a PMHx of CAD s/p PCI, HTN, HLD, recent COVID-19 infection not requiring hospitalization, who presents with worsening shortness of breath with a new exercise tolerance limited to 2-3 blocks. Subsequent cardiac catheterization revealed FFR positive mLAD and elevated LVEDP, now s/p successful PTCA and DES implantation, as well as large R internal iliac artery AVF. Patient remains symptomatic since the intervention and is now planned for endovascular treatment of severe R internal iliac artery AVF with Amplatzer occluder device and/or vascular coils.
One Response
Case would have been far easy with ipsilateral oblique (30-45 degree),in this case RAO to open up the right internal iliac branches.
Most of this case was done with LAO, making anatomy tough.