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.
Current physiologic testing for ulcer perfusion may fail to identify patients with ischemia
101 year old female, admitted to the hospital with foot and toe pain. Patient had a cool pulseless foot.
83 year old developed non healing ulcer left foot after occlusion of a known popliteal artery aneursym