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 aorta and iliac arteries. She underwent diagnostic angiogram which revealed severe disease in the distal aorta and ostial left CIA lesions, now referred for intervention.