Left SFA In-stent Restenosis Intervention – Nov 27

Case and Plan:

68 year-old female with HTN, DM, hyperlipidemia and currently smokes. Presents with BL (L>R), lifestyle limiting claudication (Rutherford 4) that has progressed to pain at rest despite OMT. Noninvasive workup showed an ABI with exercise of (R): 0.95 and 0.89 (L): 0.92 and 0.67 . Subsequent US showed in-stent restenosis of the left SFA with 1 vessel run-off below the knee. Angiogram showed left SFA/ISR with unsuccessful intervention and now referred for further intervention.

Comments

Comments (2)
Assem Mohamed Herzallah
27 Nov, 2019

Very nice case, good job.

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James Smith
27 Nov, 2019

It is unlikely that this pt would present with ‘rest pain’ given those indices. The term ‘rest pain’ is typically reserved fo those individuals who experience nocturnal pain in the distal lower extremity when they elevate their legs in bed at night. They almost always have an ABI of 0.3 or less and clinically have dependent rubor with leg dependency

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