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.
Transpedal Approach for SFA CTO Intervention
Case and Plan: 77 year-old-female with a PMHx of HTN, HLD, CAD s/p PCI (last being in 2010), AAA s/p endovascular repair 11/2019, hypothyroidism, who presented originally in 7/2020 with worsening debilitating claudication bilaterally, L to R, despite maximal medical therapy, limited to 1 block (Rutherford Grade II, Category 3). After successful revascularization of L […]
Endovascular Management of Aorto-Iliac Disease
Case and Plan: 42-year-old male with history of hypertension, type 2 diabetes and hyperlipidemia presenting with lifestyle-limiting lower extremity claudication with minimal exertion, after walking 2 blocks and resolves with rest (Rutherford grade I, category 3). Non-invasive studies suggestive aorto-iliac bifurcation disease with monophasic waveforms below the segment. Patient underwent CT Angio with bilateral iliac […]
Transradial Intervention of Iliac Disease for Chronic Limb Ischemia – November 2020
Case and Plan: Patient is a 54-year-old female smoker with known PAD, s/p R fem-pop bypass, s/p unsuccessful PTA of left SFO CTO on 10/2019 who is presenting with non-healing left foot ulcer for 2 months and associated ischemic rest pain (Rutherford grade III, category 5). Planned transradial intervention for L external iliac severe stenosis.
Complex Multilevel Intervention of CFA, SFA and AT – October 2020
Case and Plan: 80 year old female with history of diabetes, hypertension, hyperlipidemia, former smoker, PAD with prior right SFA and more recently left SFA stent placement in May 2020 (Eluvia 6.0x120mm) presenting with left sided claudication that has progressed to pain at rest.