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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50% aortic stenosis
High grade proximal RCI stenosis
Mid LCI stenosis
Occluded R ext iliac
Left ext iliac stenosis
Able to pass wire down occluded R ext iliac
4x2 balloon of proximal R CI to get 6F sheath up and over unsuccessful due to alpha looping of wire
Decided to abort treating R lesion, turned attention to aorta + L iliac system
10x40 self expanding stent
Post-stent dilatation with 6, 7, and 8mm balloons
8 x 20mm self expanding stent
Post-stent dilation using 6 and 7mm balloons
6x20mm balloon on external iliac