History : Case March 26, 2014 63 year old male patient with complaints of left calf pain (Typical Claudication) at rest and on exertion (Fontaine II/B).

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Presentation transcript:

History : Case March 26, 2014 63 year old male patient with complaints of left calf pain (Typical Claudication) at rest and on exertion (Fontaine II/B). Past Medical History: Hypertension, Dyslipidemia Medications: Aspirin, clopidogrel, amlodipine, lisinopril, simvastatin, cilostazol Social History: Ex-Smoker, no alcohol or IVDA

Pertinent Physical Exam Vitals: 136/78, 80/min, 16/min, 98F, 96% O2sat Peripheral: Pulses Doppler – DP/PT bilaterally, no skin breakdown or tenderness. Imaging Resting ABI showed 0.80 in right and 0.65 in left lower extremity. Peripheral Angiogram: showed Borderline obstructive disease of the right common femoral artery, popliteal artery with significant stenosis of the proximal right anterior tibial and distal posterior tibial artery. Significant stenosis in the left external iliac artery s/p successful stent placement , Chronic total occlusion of the Mid left superficial femoral artery (SFA) with significant calcification and obstructive disease the left anterior tibial artery. Patient currently planned for an endovascular intervention of the long segment calcified SFA chronic total occlusion.