Case and plan:
67-year-old male referred for bilateral lifestyle-limiting claudication progressive to ischemic rest pain (L>R) with < 1 block of activity (Rutherford Grade II, Category 4).
PMHx: CAD s/p 1V CABG (2019) in DR c/b CHB s/p PPM, HFrEF 2/2 ICM, Subclavian thrombosis on lifelong AC, PVD s/p left GSV RFA (2022), HTN, HLD, NIDDMII
Social Hx: Never smoker
Medications: Warfarin, Plavix, Crestor, Zetia, Entresto, Carvedilol, Lasix
Access:
- Contralateral RIGHT CFA access with 6F Destination long sheath
- Left pedal access (+/-)
Adjunctive Therapy:
- Atherectomy (+/-)
- Atherotomy (+/-)
Destination Therapy:
- DCB vs Stent
- PTA vs Atherotomy BTK
