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.
Percutaneous bypass graft for severe critical limb ischemia
61 year old male, diabetic, developed a lateral right foot ulcer after a pedicure. The posterior tibial artery pulse was palpable.
62 year old female with 2 months of short distance claudication and rest pain at night