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.
