Multilevel Complex Fem/Pop and BTK CTO – December 2023

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


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