Case and Plan:
•68 F with HTN, HLD, obesity s/p gastric bypass, carotid stenosis s/p CEA, known PAD s/p several interventions. Presents with severe bilateral claudication with < 0.5 block walking (Rutherford 3), L > R.
•Angiogram reveals ostial SFA ISR lesion as well as popliteal CTO reconstituting at the trifurcatio
•Planned for Endovascular intervention of femoro-popliteal obstructive disease with severe claudication, including popliteal CTO lesion possibly necessitating pedal approach