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Endovascular / Lower limbs / Fempop / Case in the box
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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

  1. Controlateral femoral access

  2. 6F braided introducer - long lesion (10cm) from distal to tibial artery

  3. Subintimal or intraluminal angioplasty at level of SFA

  4. Dilatation and stenting proximal part (Eluvia)

  5. Tibioperoneal trunk angioplasty : 3.5/3 balloon - 3.5/28 Promus stent

  6. Preservation of posterior tibial artery - excellent vascularization of a foot 

  7. 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
Max Amor
Essey-lès-Nancy, France
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9 comments
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See previous comments (2)
  • arie B.

    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 ?/

    2016-11-16, 17h22
    • Max A.

      Max A. Our experience is satisfactory in this territory for such anatomy . Thank you for your comment Arie.

      2017-08-01, 9h44
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  • Segal D.

    Segal D. Nice job! What are your thoughts about athrectomy ?

    2016-12-30, 10h13
    • Max A.

      Max A. We use atherectomy infrequently because of the cost ...

      2017-08-01, 9h45
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  • narayana reddy B.

    narayana reddy B. Nice case and nice demonstration

    2017-07-12, 16h43
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    • marcus P.

      marcus P. Very Good!

      2017-08-01, 9h23
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      • Max A.

        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

        2017-08-01, 9h41
        • Nazar N.

          Nazar N. You are great teacher ..God bless you..

          2020-03-26, 20h44
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      • Nazar N.

        Nazar N. Excellent

        2020-03-13, 17h45
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