56 year old male, life long smoker, presents with severe bilateral lower extremity claudication. At initial visit, medical management and risk factors were addressed. Trial of management with Pletal failed at 1 month due to side effects. Patient's employment was at risk due to limitations in walking. CT angiography showed left external iliac, common femoral and superficial femoral artery occlusions. Endovascular therapy was performed with angioplasty and stenting the left EIA and JetStream atherectomy of the left CFA. At 31 months the left EIA and CFA remain patent.
62 year old female suffering for 30 years with pelvic venous congestion
87 year old male with a right groin pseudoaneurysm due to the dehisences of the fabric of an aorto bifemoral bypass graft
Recurrent lower extermity DVT should prompt an investigation for venous outflow obstruction. Too often these patients are under treated.