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.