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.
Review of the technique of Foam Phlebectomy
Presentation at Charring Cross Meeting London 2015
The tip of a hydrophilic wire was fractured and subsequently retrieved during the crossing of a distal anterior tibial artery near occlusion