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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
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