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).
Suggestions
Transpedal Approach for SFA CTO Intervention
350 Case and Plan: 77 year-old-female with a PMHx of HTN, HLD, CAD s/p PCI (last being in 2010), AAA s/p endovascular repair 11/2019, hypothyroidism, who presented originally in 7/2020 with worsening debilitating claudication bilaterally, L to R, despite maximal medical therapy, limited to 1 block (Rutherford Grade II, Category 3). After successful revascularization of L […]
Endovascular Management of Aorto-Iliac Disease
343 Case and Plan: 42-year-old male with history of hypertension, type 2 diabetes and hyperlipidemia presenting with lifestyle-limiting lower extremity claudication with minimal exertion, after walking 2 blocks and resolves with rest (Rutherford grade I, category 3). Non-invasive studies suggestive aorto-iliac bifurcation disease with monophasic waveforms below the segment. Patient underwent CT Angio with bilateral iliac […]
Transradial Intervention of Iliac Disease for Chronic Limb Ischemia – November 2020
225 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
214 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.