Findings: Peripheral Arteriogram with Intervention Indication: 57 year old underwent Peripheral Arteriogram with Intervention for evaluation of peripheral arterial disease due to Rutherford III with the following symptoms, Chronic Limb Ischemia and multiple PAD risk factors along with an abnormal non-invasive study. Procedures: Ultrasound guided Left Femoral artery access Selective Abdominal Aorta, Right Iliac, Right SFA, Right Lower Extremity, Left Iliac, Left SFA, Left Lower Extremity DSA angiography IVUS measurements taken of the, Right Anterior Tibial, Right Popliteal, Right SFA PTA (balloon angioplasty) with atherectomy of the, Right Anterior Tibial PTA (balloon angioplasty) with atherectomy of the, Right Popliteal, Right SFA Approach: Left Femoral Artery Conclusion: Intervention: Successful PTA (balloon angioplasty) with atherectomy of the, Right Anterior Tibial PTA (balloon angioplasty) with atherectomy of the, Right Popliteal, Right SFA Complications: No complications during procedure Recommendations: Plavix 75mg daily for 3 months and Aspirin 81 mg po q day for lifelong, Aggressive risk factor modification, Continue lipid lowering therapy.: Disposition: Same day discharge. Follow up appointment with, Dr
Diagnostic Findings: Abdominal Aorta, minimal atherosclerotic disease with less than 10% stenosis Right Common Iliac, minimal atherosclerotic disease with less than 10% stenosis Right External Iliac, minimal atherosclerotic disease with less than 10% stenosis Right Common Femoral, minimal atherosclerotic disease with less than 10% stenosis Right SFA, minimal atherosclerotic disease with less than 10% stenosisRight Profunda, minimal atherosclerotic disease with less than 10% stenosis Right Popliteal, minimal atherosclerotic disease with less than 10% stenosis Right Tibial Peroneal Trunk, minimal atherosclerotic disease with less than 10% stenosis Right Anterior Tibial, 100% chronic total occlusion Right Peroneal, minimal atherosclerotic disease with less than 10% stenosis Right Posterior, 100% chronic total occlusion Right Dorsalis Pedis, minimal atherosclerotic disease with less than 10% stenosis Left Common Iliac, minimal atherosclerotic disease with less than 10% stenosis Left External Iliac, minimal atherosclerotic disease with less than 10% stenosis Left Common Femoral, minimal atherosclerotic disease with less than 10% stenosis Intervention: Heparin, Plavix, 2% Lidocaine Patient presents to the cardiac catheterization lab with complains of Claudication with Rutherford III with the following symptoms, Chronic Limb Ischemia. Indication: 57 year old underwent Peripheral Arteriogram with Intervention: Claudication for evaluation of peripheral arterial disease due to Rutherford III with the following symptoms, Chronic Limb Ischemia and multiple PAD risk factors along with an abnormal non-invasive study. After informed consent was obtained, the patient was brought to the peripheral catheterization laboratory. The patient was prepped and draped in the usual sterile manner. 1% lidocaine was used for local anesthesia and the patient was sedated as per endovascular lab protocol. Access was obtained in the Left Femoral Artery using the modified Seldinger technique 5 French Sheath was placed in the left femoral artery under fluoroscopy and ultrasound guidance.. Catheter Pathway: Ultrasound guided Left Femoral artery access Selective Abdominal Aorta, Right Iliac, Right SFA, Right Lower Extremity, Left Iliac, Left SFA, Left Lower Extremity DSA angiography IVUS measurements taken of the, Right Anterior Tibial, Right Popliteal, Right SFA PTA (balloon angioplasty) with atherectomy of the, Right Anterior Tibial PTA (balloon angioplasty) with atherectomy of the, Right Popliteal, Right SFA Detailed Procedure: After obtaining informed consent, the patient was brought to the catheterization suite in a postabsorptive and non-sedated state. After this, a timeout was performed and subsequently moderate sedation was given to the patient. Using the modified seldinger technique a 5 French Sheath was placed in the left femoral artery under fluoroscopy and ultrasound guidance.. left SFA was performed. Then a French diagnostic catheter was advanced to the abdominal aorta, where selective abdominal and Iliac DSA angiography was performed. Then the catheter was advanced
over a 0.035 inch glide wire to the right SFA where selective DSA angiography was taken of the SFA and lower extremity was performed. After reviewing the angiographic findings,A 45 cm terumo sheath was advanced over a wire and placed at the level of the right femoral artery.IVUS measurements taken of the, Right Anterior Tibial, Right Popliteal, Right SFA. CSI atherectomy device was advanced over the viper wire to the measured vessels where multiple runs were made. This was followed by balloon angioplasty using a, 2.5 x 300mm balloon which was serially inflated.This was followed by balloon angioplasty using a, 6.0x 220mm balloon which was serially inflated. All catheters and wires were removed with Angioseal closure device was used to obtain hemostasis of the access site. The patient tolerated the procedure well and remained hemodynamically stable throughout the procedure. Lesions: Procedure; Atherectomy, Balloon, Catheter Pinnacle Destination / 6 F/ 45 cm, Guidewire Viper Wire / 300 / 14, IVUS: Philips, Atherectomy Size CSI 1.50 mm Completion angiography was performed which revealed an excellent interventional result with no change in distal runoff post intervention. Vascular Closure Device: Illeo-Femoral angiogram revealed femoral artery suitable for vascular closure. Angioseal closure device was successfully deployed in the left femoral artery. Contrast Media: Equipment: Mirco Access Kit Stiff/10/4, Pinnacle Destination/45/6, Soft angled glide wire Conclusions: Successful PTA (balloon angioplasty) with atherectomy of the, Right Anterior Tibial PTA (balloon angioplasty) with atherectomy of the, Right Popliteal, Right SFA Conscious Sedation: 65 minutes Start Time: 1130 End Time: 1235 Total Procedure Time: 65 minutes Fifteen Minute Intervals: 4Fluoro Time: 4.3 Dosage: 30.14 mGy
Diagnostic Findings: Abdominal Aorta, minimal atherosclerotic disease with less than 10% stenosis Right Common Iliac, minimal atherosclerotic disease with less than 10% stenosis Right External Iliac, minimal atherosclerotic disease with less than 10% stenosis Right Common Femoral, minimal atherosclerotic disease with less than 10% stenosis Right SFA, minimal atherosclerotic disease with less than 10% stenosisRight Profunda, minimal atherosclerotic disease with less than 10% stenosis Right Popliteal, minimal atherosclerotic disease with less than 10% stenosis Right Tibial Peroneal Trunk, minimal atherosclerotic disease with less than 10% stenosis Right Anterior Tibial, 100% chronic total occlusion Right Peroneal, minimal atherosclerotic disease with less than 10% stenosis Right Posterior, 100% chronic total occlusion Right Dorsalis Pedis, minimal atherosclerotic disease with less than 10% stenosis Left Common Iliac, minimal atherosclerotic disease with less than 10% stenosis Left External Iliac, minimal atherosclerotic disease with less than 10% stenosis Left Common Femoral, minimal atherosclerotic disease with less than 10% stenosis Intervention: Heparin, Plavix, 2% Lidocaine Patient presents to the cardiac catheterization lab with complains of Claudication with Rutherford III with the following symptoms, Chronic Limb Ischemia. Indication: 57 year old underwent Peripheral Arteriogram with Intervention: Claudication for evaluation of peripheral arterial disease due to Rutherford III with the following symptoms, Chronic Limb Ischemia and multiple PAD risk factors along with an abnormal non-invasive study. After informed consent was obtained, the patient was brought to the peripheral catheterization laboratory. The patient was prepped and draped in the usual sterile manner. 1% lidocaine was used for local anesthesia and the patient was sedated as per endovascular lab protocol. Access was obtained in the Left Femoral Artery using the modified Seldinger technique 5 French Sheath was placed in the left femoral artery under fluoroscopy and ultrasound guidance.. Catheter Pathway: Ultrasound guided Left Femoral artery access Selective Abdominal Aorta, Right Iliac, Right SFA, Right Lower Extremity, Left Iliac, Left SFA, Left Lower Extremity DSA angiography IVUS measurements taken of the, Right Anterior Tibial, Right Popliteal, Right SFA PTA (balloon angioplasty) with atherectomy of the, Right Anterior Tibial PTA (balloon angioplasty) with atherectomy of the, Right Popliteal, Right SFA Detailed Procedure: After obtaining informed consent, the patient was brought to the catheterization suite in a postabsorptive and non-sedated state. After this, a timeout was performed and subsequently moderate sedation was given to the patient. Using the modified seldinger technique a 5 French Sheath was placed in the left femoral artery under fluoroscopy and ultrasound guidance.. left SFA was performed. Then a French diagnostic catheter was advanced to the abdominal aorta, where selective abdominal and Iliac DSA angiography was performed. Then the catheter was advanced
over a 0.035 inch glide wire to the right SFA where selective DSA angiography was taken of the SFA and lower extremity was performed. After reviewing the angiographic findings,A 45 cm terumo sheath was advanced over a wire and placed at the level of the right femoral artery.IVUS measurements taken of the, Right Anterior Tibial, Right Popliteal, Right SFA. CSI atherectomy device was advanced over the viper wire to the measured vessels where multiple runs were made. This was followed by balloon angioplasty using a, 2.5 x 300mm balloon which was serially inflated.This was followed by balloon angioplasty using a, 6.0x 220mm balloon which was serially inflated. All catheters and wires were removed with Angioseal closure device was used to obtain hemostasis of the access site. The patient tolerated the procedure well and remained hemodynamically stable throughout the procedure. Lesions: Procedure; Atherectomy, Balloon, Catheter Pinnacle Destination / 6 F/ 45 cm, Guidewire Viper Wire / 300 / 14, IVUS: Philips, Atherectomy Size CSI 1.50 mm Completion angiography was performed which revealed an excellent interventional result with no change in distal runoff post intervention. Vascular Closure Device: Illeo-Femoral angiogram revealed femoral artery suitable for vascular closure. Angioseal closure device was successfully deployed in the left femoral artery. Contrast Media: Equipment: Mirco Access Kit Stiff/10/4, Pinnacle Destination/45/6, Soft angled glide wire Conclusions: Successful PTA (balloon angioplasty) with atherectomy of the, Right Anterior Tibial PTA (balloon angioplasty) with atherectomy of the, Right Popliteal, Right SFA Conscious Sedation: 65 minutes Start Time: 1130 End Time: 1235 Total Procedure Time: 65 minutes Fifteen Minute Intervals: 4Fluoro Time: 4.3 Dosage: 30.14 mGy