Critical Limb Ischemia – Multilevel Disease – May 2018
71 year old female with history of type 2 DM, hypertension, dyslipidemia and stage 3 CKD. No known peripheral vascular disease. Patient was doing well until about 4 months ago, when she noticed an ulcer on her right first toe, associated with pain. She also reports pain in her foot, which is relieved in dependent position. She was evaluated at an outside hospital and after ‘work up’ was told that she needs an ‘amputation’. She was referred by her PCP for a second opinion. Review of work up showed ABI of 0.43 on right and 0.78 on left side. Arterial duplex was reported as subtotal occlusion of the right SFA and occlusion of right AT and PT in mid-segment. On examination, she has a 3 x 2 cm ulcer on the first toe associated with minimal exudate.
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.
Transradial Approach for CFA Intervention Involving Fem-Fem Bypass Graft – July 2020
Case and Plan: 70 year-old male with a PMHx of HTN, HLD, asthma, NIDDM, CKD Stage III, HFpEF (55%), MGUS, CAD s/p 2vCABG and PAD s/p bilateral common iliac stent c/b left common iliac artery stent occlusion s/p R->L fem-fem bypass who is presenting with progressive claudication now present at rest (Rutherford 4). Lower extremity […]