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Case summary
- 81 Years old male
- Risk factors : former smoker
- Medical history : ischemic heart disease (triple coronary bypass), lower limb artery disease, right carotid angioplasty( PRECISE, 2016)
- Clinical symptoms : bilateral lower limb intermittent claudication stage 2b
- Biological parameters : serum creatinine 11mg/L
- On going treatement : aspirin, clopidogrel, bisoprolol, ramipril, atorvastatine 20mg
Strategy
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Controlateral femoral access
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6F braided introducer - long lesion (10cm) from distal to tibial artery
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Subintimal or intraluminal angioplasty at level of SFA
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Dilatation and stenting proximal part (Eluvia)
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Tibioperoneal trunk angioplasty : 3.5/3 balloon - 3.5/28 Promus stent
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Preservation of posterior tibial artery - excellent vascularization of a foot
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Final assesment and treatment of TPT stenosis : good preservation of SFA - proximal popliteal artery and tibioperoneal trunk
Diagnostic images
Shooting date : 2016-07-13
Last update : 2021-06-09
Last update : 2021-06-09
Promus PREMIER™ / Boston Scientific
Everolimus-Eluting Platinum Chromium Coronary Stent System
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Suggestions
Tandem lesions: high grade stenosis proximal SFA and total P3 occlusion treated with Ranger DCB
Dr Deloose & Dr Rastan
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arie B. 80 years old with claudication in mid range is not highly symptomatic and the procedure is not indicated how long this remained open ?/
Max A. Our experience is satisfactory in this territory for such anatomy . Thank you for your comment Arie.
Segal D. Nice job! What are your thoughts about athrectomy ?
Max A. We use atherectomy infrequently because of the cost ...
narayana reddy B. Nice case and nice demonstration
marcus P. Very Good!
Max A. 1 I think the procedure is highly justified ,this patient even at 80 needed to walk . We have an experience of DES in this location since 2003 and we are satisfied in selected indications
2 we do not use atherectomy routinely
3 thank you for your comments
Nazar N. You are great teacher ..God bless you..
Nazar N. Excellent