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.
67 year old male, type1 diabetic, with painful ulceration at the tip of the second toe. Patient did not toe amputation.
Percutaneous bypass graft for severe critical limb ischemia
83 year old male, Type I Diabetes, end stage renal disease, living independently who was told he needed a below knee amputation.