History physical
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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

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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


History physical

50% aortic stenosis

High grade proximal RCI stenosis

Mid LCI stenosis

Occluded R ext iliac

Left ext iliac stenosis


History physical

Able to pass wire down occluded R ext iliac


History physical

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

Decided to abort treating R lesion, turned attention to aorta + L iliac system


History physical

10x40 self expanding stent


History physical

Post-stent dilatation with 6, 7, and 8mm balloons


History physical

8 x 20mm self expanding stent

Post-stent dilation using 6 and 7mm balloons


History physical

6x20mm balloon on external iliac


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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