Case and Plan:
History of Presenting Illness
• 63 year old gentleman with BL LE claudication, L R, despite maximal conservative therapy, including 12 week exercise program. Not candidate for cilostazol due to heart failure.
• PMH: HTN, HF w/reduced EF, ESRD on HD, NSTEMI s/p PCI RCA 6/2025 and LAD 10/2025,
DM, brain aneurysm s/p craniotomy
• Social: No tobacco, alcohol, or other drug use
• Medications: aspirin, clopidogrel, rosuvastatin, sacubitril-valsartan, hydralazine
Imaging
• Echo: LVEF 35%
• ABI: Left 0.45, Right 0.49
• US: Severe BL SFA disease
• Diagnostic angiogram: BL SFA CTO, BL severe popliteal disease
