92 year old female with left foot rest pain and worsening ulcers of typical of ischemia. CTA demonstrated severe PAD with heavy calcification in the femoral, popliteal, tibial and pedal arteries with a solid wall of calcium at the adductor canal. These types of lesions are often difficult to cross and often result in a subintimal or extra luminal crossing subsequently requiring the use of reentry devices and/or retrograde access to successfully treat. In this case, the occlusion could no be crossed using traditional catheter and wire techniques. A 21g Chiba needle was used to successful cross the lesion and treatment was completed using atherectomy and stenting.
Painful varicoceles interfering with high school athletics
94 year old female, worsening right toe and foot pain. Seen by primary care and diagnosed as having gout.
87 year old male with a right groin pseudoaneurysm due to the dehisences of the fabric of an aorto bifemoral bypass graft