1. LIVE CASE PRESENTATION MOUNT SINAI CARDIAC CATH LAB
WEDNESDAY, MARCH 22, 2017

2. HISTORY OF PRESENT ILLNESS
Patient is an 66 year old male with a history of diabetes mellitus, hypertension, hyperlipidemia, CAD s/p CABG, ICM EF 10%
Has a history of peripheral arterial disease s/p left common iliac artery stent
Presents with worsening 1 block lifestyle limiting severe right lower extremity claudication (Rutherford Grade 1, Category 3, Fontaine Stage IIB)
Claudication symptoms have been getting progressively worse. No significant improvement with exercise program and medical therapy
No rest pain or ischemic ulcers noted

3. CAD s/p CABG (LIMA to LAD, SVG to OM1, SVG to RPDA)
PAST MEDICAL HISTORY
Diabetes Mellitus
Hypertension
Hyperlipidemia
Peripheral arterial disease s/p left common iliac artery stent (Absolute 10 x 60 mm)
CAD s/p CABG (LIMA to LAD, SVG to OM1, SVG to RPDA)
Ischemia Cardiomyopathy EF 10%

4. MEDICATIONS
ASA
Clopidogrel
Atorvastatin
Furosemide
Carvedilol
Valsartan
Insulin
Gabapentin
ALLERGIES
Contrast dye- hives (premedicated)
SOCIAL HISTORY
Smoking: 30 pyh Quit 10 years ago
Alcohol Use: None
Drug Use: None
FAMILY HISTORY
None
ROS
Negative aside from above

5. PHYSICAL EXAMINATION
Vital- BP 126/60 Pulse 70 Resp 14 Afebrile
Neck- No carotid bruits
CV- RRR no murmurs/rubs/gallops
Resp- CTAB
Ext- Diminished 1+ left DP and PT pulses. 1+ right DP and PT pulses. No ischemic ulcers.
LABS
HGB 13.0
PLT 200
CR 1.0
INR 1.0
ABI
Right ABI 0.52
VASCULAR ARTERIAL ULTRASOUND
50-99% right SFA stenosis

15. CASE PRESENTATION SUMMARY
66 year old male with diabetes, hypertension, hyperlipidemia, CAD s/p CABG, ICM EF 10%, and PAD s/p left CIA stent
Patient presents with 1 block lifestyle limiting right lower extremity claudication
Abnormal right ABI of 0.52
Peripheral angiogram reveals CTO of the right ostial SFA with distal SFA reconstitution and 2 vessel runoff
Plan: Right SFA intervention