60 year old female, smoker, underwent aorto-bifemoral bypass graft placement for severe iliac artery occlusive disease and short distance claudication. Patient had symptomatic improvement but quickly deteriorated on the right with worse symptoms than prior to surgery. Exercise ABI's showed severe PAD with claudication at 125 yards. Patient was at risk of losing employment - patient works in a Walmart warehouse and could not walk quickly or far enough. Patient did not want another open procedure. Endovascular repair was accomplished in 60 minutes using atherectomy and angioplasty. Patient returned to work the next day symptom free. In addition, the patients rest pain and night resolved.
Unusual cause of extremity pain in a diabetic patients
Iliac vein compression may cause pelvic venous congestion.
Renal vein stent placed for Nutracker Syndrome was placed too far into the IVC and causing pain. Stent was partially removed.