76 year old male presents with left 2nd toe non healing ulcer (dorsal aspect) (Rutherford Class III – Category V). His risk factors include CAD s/p PCI to mLAD, hypertension, DM, dyslipidemia and ex-smoker. He currently takes Aspirin, Simvastatin, Norvasc, Carvedilol, Gabapentin, Glipizide, Insulin and antibiotics. His work up showed ABI of 0.4 in left lower extremity and US Duplex showed monophasic waveforms with severe stenosis of Left SFA and infrapopliteal vessels. He underwent Peripheral angiogram that showed severe stenosis of Left EIA, Left SFA and occluded L AT and L PT. He then underwent Left external Iliac artery Bare Metal Stenting on 07/20/2015 and LSFA Directional Athrectomy and Drug Eluting stenting on 09/14/2015. Left 2nd toe ulcer is not completely healed. Now planned for Antegrade/Retrograde approach Percutaneous Transluminal Angioplasty of L AT.
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 […]