64 year old female with a 2 year history of worsening left calf claudication. Pain has become severe enough the patient is having a hard time working and staying employed. CT angiography showed a heavily calcified common femoral artery plaque causing near occlusion of the artery. Retrograde superficial femoral access with directional atherectomy was attempted but limited due to difficulty getting the cutting blade to engage the plaque. Using external compression to assist the atherectomy resulted in significant plaque removal and luminal gain. Patient had normalization of their ABI's and was able to work pain free 2 days after the procedure.
Review of the clinical findings and their usefulness in identifying patients with peripheral arterial disease
61 year old male, diabetic, developed a lateral right foot ulcer after a pedicure. The posterior tibial artery pulse was palpable.
82 year old male, heavy smoker, developed right heel ulcer during rehab after a femur fracture.