1. History : Case June 18’ 2014
59 year old male patient with complaints of life style limiting claudication symptoms in right leg at rest (Rutherford Grade II category 4) on medication (cilostazol) and exercise program on presentation.
Past Medical History: Hypertension, Dyslipidemia, DM type II, HIV
Medications: Medications: Aspirin, cilostazol, Metoprolol, Amlodipine, Atorvastatin
Social History: Non Smoker, no alcohol or IVDA

2. Pertinent Physical Exam
Vitals: 134/72, 72/min, 16/min, 98F, 96% O2sat
Peripheral: Pulses Doppler – DP/PT bilaterally, no tissue loss, no erythema
Imaging
ABI/PVR with result of 0.65 on the right, 0.82 on left at rest
Arterial doppler showed total occlusion of the right distal SFA with moderate calcification
Peripheral Angiogram: Right Distal SFA chronic total occlusion with two vessel runoff distally with occluded anterior tibial. Moderate diffuse disease of left SFA with three vessel runoff.
Plan
Patient now planned for Recanalizaton of CTO, calcified right distal superficial femoral artery.

3. TASC II Femero-popliteal lesion classification