80 year old female patient with past medical history of hypertension, dyslipidemia, diabetes mellitus type II, 40 pack year smoking history presents with complaints of bilateral claudication in calf with right left leg (Rutherford class I category 3). Patient had ABI/PVR which showed 0.7 on the right and 0.82 on the left with waveforms suggestive of femeropopliteal disease. Peripheral angiogram performed showed chronic total occlusion (CTO) of the ostial right superficial femoral artery (SFA), CTO of the right anterior tibial and posterior tibial artery. Boderline stenosis of the left common iliac artery, significant stenosis of the left superficial femoral artery, left peroneal artery and CTO of the left anterior tibial noted. Patient currently planned for an endovascular intervention of the CTO of ostial right SFA via retrograde approach. We will discuss about the endovascular indications, approach towards complex SFA CTO via retrograde approach.
Transradial Intervention of Iliac Disease for Chronic Limb Ischemia – November 2020
Case and Plan: Patient is a 54-year-old female smoker with known PAD, s/p R fem-pop bypass, s/p unsuccessful PTA of left SFO CTO on 10/2019 who is presenting with non-healing left foot ulcer for 2 months and associated ischemic rest pain (Rutherford grade III, category 5). Planned transradial intervention for L external iliac severe stenosis.
Complex Multilevel Intervention of CFA, SFA and AT – October 2020
Case and Plan: 80 year old female with history of diabetes, hypertension, hyperlipidemia, former smoker, PAD with prior right SFA and more recently left SFA stent placement in May 2020 (Eluvia 6.0x120mm) presenting with left sided claudication that has progressed to pain at rest.
Management of Aortoiliac Disease (CERAB Technique) – September 2020
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 […]
LEFT SFA CTO REVASCULARIZATION – August 2020
Case and Plan: 55 year-old-male with mutliple comorbidities, who presents with ongoing, bilateral lifestyle-limiting claudication now progressed to rest pain (L>R) who is status post R SFA CTO intervention and now planned for L SFA CTO intervention via femoral approach.