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History & Physical. 77 yo retired physician with B LE claudication, R>L. PMH: CAD s/p CABG +AVR 12/03, prostate CA, HTN Exam: diminished L femoral pulse, no R femoral pulse, nonpalpable distal pulses, no tissue changes Lab: ABI=0.34 right, 0.30 on L. 50% aortic stenosis.

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history physical
History & Physical
  • 77 yo retired physician with B LE claudication, R>L.
  • PMH: CAD s/p CABG +AVR 12/03, prostate CA, HTN
  • Exam: diminished L femoral pulse, no R femoral pulse, nonpalpable distal pulses, no tissue changes
  • Lab: ABI=0.34 right, 0.30 on L
slide2

50% aortic stenosis

High grade proximal RCI stenosis

Mid LCI stenosis

Occluded R ext iliac

Left ext iliac stenosis

slide5

4x2 balloon of proximal R CI to get 6F sheath up and over unsuccessful due to alpha looping of wire

slide10

8 x 20mm self expanding stent

Post-stent dilation using 6 and 7mm balloons

follow up
Follow-Up
  • Seen back in clinic one month later with resolution of L claudication
  • Walking significantly improved in terms of L leg, able to walk from parking lot to vascular center without stopping.
  • Still c/o R leg claudication
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