62 year old female, heavy smoker, noticed a relatively sudden worsening of chronic right calf claudication. Ultrasound and CT angiography demonstrated occlusion of the common femoral artery. The patient is overweight with a body mass index of 35. The patient was self employed and did not want, nor could afford the time off work to under go a common femoral endarterectomy. Endovascular repair with pathway atherectomy in a 60 minute procedure. Patient spent a total of 4 hours at our out patient center and was back at work the next day. At 6 months, the patient has stopped smoking, and remains symptom free. Optimal medical therapy with blood pressure control, statin and dual antiplatelet therapy. Arterial ultrasound shows a widely patent CFA and exercise ABI's are essentially normal.
79 year old female with non healing ulcers. Occlusion of all three arteries in the calf.
Nutcracker syndrome is one of the causes of secondary pelvic congestion syndrome.
The tip of a hydrophilic wire was fractured and subsequently retrieved during the crossing of a distal anterior tibial artery near occlusion