54 year old woman presents with slowly healing R foot 1st and 5th toe ulcer (plantar aspect)(Rutherford Grade III – Category V, Fontaine stage IV, Wifi 1, 2, 1). Her past medical history includes Hypertension, NIDDM and Hyperlipidemia. Her medications include Aspirin, Metoprolol, Zocor, metformin and antibiotics. She underwent ABI that was 0.3 in right lower extremity and 0.8 in left lower extremity. US Duplex showed severe stenosis of RSFA with occluded RAT and RPER and severe stenosis of RPT. She underwent peripheral angiogram and had RSFA Directional athrectomy, Zilver stenting of mid segment 2 weeks ago. Here for Percutaneous Transluminal Angioplasty of RAT (RPT if needed to complete plantar arch).
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