1. History : Case April’ 2014
80 year old female patient with past medical history of presents with complaints of bilateral claudication in buttocks, hip and calf with left > right leg (Rutherford class I category 3)
Past Medical History: Hypertension, Dyslipidemia, Asthma, CAD s/p CABG
Medications: Zocor, Lisinopril, Carvedilol, Prilosec, Ferrous Sulfate, Meloxicam, Alendronate, Vitamin B12, Cilostazol. Aspirin, albuterol
Social History: Ex-Smoker, no alcohol or IVDA

2. Pertinent Physical Exam
Vitals: 125/72, 70/min, 16/min, 98F, 96% O2sat
Peripheral: Pulses Doppler – DP/PT bilaterally
Imaging
ABI/PVR: showed 0.72 on the right and 0.44 on the left with waveforms suggestive of aortoiliac disease
Peripheral Angiogram: showed significant stenosis of the distal aorta, ostial right common iliac artery stenosis and chronic total occlusion (CTO) of the left common iliac with reconstitution at the proximal left external iliac (Image A). Boderline stenosis of the left superficial femoral artery and right posterior tibial artery also noted.
Patient currently planned for an endovascular intervention of the CTO of left common iliac and distal aortic / common iliac bifurcation