78- year- old male patient with past medical history of hypertension, dyslipidemia, CAD s/p CABG, CKD stage II, type II DM, CVA, and mild intermittent asthma presented with complaints of left leg pain with non- healing ulcer along the dorsal surface of the foot (Rutherford class III category 5, Fontaine IV). Peripheral angiogram performed showed significant stenosis of mid left superficial femoral artery, CTO of the mid left anterior tibial artery, CTO of the left tibioperoneal trunk, distal reconstitution of the left peroneal artery and left posterior tibial artery via the proximal anterior tibial collaterals, including distal reconstitution of the dorsalis pedis via the peroneal artery collaterals.
Plan: Patient is currently scheduled for endovascular treatment of the CTO of the left tibioperoneal trunk.
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 […]
Chronic total occlusion (CTO) of left popliteal artery – June 2020
Case and Plan: This is a 68 F with hypertension, diabetes, dyslipidemia and peripheral arterial disease who had prior interventions of the right lower extremity. She presented to the office with life style limiting claudication that has progressed to pain at rest despite optimal medical and exercise therapy. Non invasive studies showed severely reduced ABI […]