bevann0402@bellsouth.net
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I have no idea where to start on this one. TIA for your help and suggestions.
Indication: claudication, PVD, leg pain
Procedures performed:
1. distal aortogram, with bilateral lower extremity runoff
2. selevtive angiography of the left common iliac artery
3. selective angiography of the left external iliac artery
4. selective angiography of the left superficial femoral artery
5. selective angiography of the left popliteal trunk
6. selective angiography of the right common iliac artery
7. selective angiography of the right external iliac artery
8. successful atherectomy to the distal left superficial femoral artery, with extension into the popliteal trunk, with 90% lesion reduced to less than 10%.
pt. underwent 6 French sheath placement in right common femoral artery with a mild amount of difficulty.
next we took a pigtail catheter up into the distal aorta and distal aortogram w/runoff was performed. distal aorta showing some calcification and mild narrowing. the right common iliac artery, rt external iliac artery, rt internal iliac artery are all widely patent. right common femoral artery heavily calcified. with 30% to 40% plaque throughout. the rt superficial femoral artery is patent w/ mild disease until it gets into the distal vessel. it becomes a chronic total occlusion and has self collaterals and reconstitutes at the popliteal artery.
next the pigtail catheter was exchanged out with a long Wholey wire and an imaging catheter was used and placed down into the left common femoral artery. angiography was then performed demonstrating the left common femoral artery is widely patent. the left superficial femoral artery widely patent down into its distal vessel, where there is a 90% lesion seen prior to the opening up into the popliteal artery. from pigtail catheter we know that the left common iliac artery and left external iliac artery are all widely patent. next we changed out the short sheath for a 7x45 terumo. a trailblazer catheter, 0.035x150 was used for our imaging. we successfully went down to place a 6.0 spider filter down into the left popliteal trunk. angiomax was started.
next we took a turbohawk LSC atherectomy device. there was a total of 9 passes made along the distal left SFA into the popliteal trunk. Final angiography was performed with and without wire in place. the 90% lesion wwas reduced to less than 10%. I see no indications for stenting here, or balloon angioplasty. we did remove the long 7x45 terumo, and replaced it with a 7 short French sheath, into the right common femoral artery. patient left lab in stable condition with recommendation for a stage II procedure to the right distal superficial femoral artery to try to collect the CTO at a later date.
thanks
Beverly,CPC
Indication: claudication, PVD, leg pain
Procedures performed:
1. distal aortogram, with bilateral lower extremity runoff
2. selevtive angiography of the left common iliac artery
3. selective angiography of the left external iliac artery
4. selective angiography of the left superficial femoral artery
5. selective angiography of the left popliteal trunk
6. selective angiography of the right common iliac artery
7. selective angiography of the right external iliac artery
8. successful atherectomy to the distal left superficial femoral artery, with extension into the popliteal trunk, with 90% lesion reduced to less than 10%.
pt. underwent 6 French sheath placement in right common femoral artery with a mild amount of difficulty.
next we took a pigtail catheter up into the distal aorta and distal aortogram w/runoff was performed. distal aorta showing some calcification and mild narrowing. the right common iliac artery, rt external iliac artery, rt internal iliac artery are all widely patent. right common femoral artery heavily calcified. with 30% to 40% plaque throughout. the rt superficial femoral artery is patent w/ mild disease until it gets into the distal vessel. it becomes a chronic total occlusion and has self collaterals and reconstitutes at the popliteal artery.
next the pigtail catheter was exchanged out with a long Wholey wire and an imaging catheter was used and placed down into the left common femoral artery. angiography was then performed demonstrating the left common femoral artery is widely patent. the left superficial femoral artery widely patent down into its distal vessel, where there is a 90% lesion seen prior to the opening up into the popliteal artery. from pigtail catheter we know that the left common iliac artery and left external iliac artery are all widely patent. next we changed out the short sheath for a 7x45 terumo. a trailblazer catheter, 0.035x150 was used for our imaging. we successfully went down to place a 6.0 spider filter down into the left popliteal trunk. angiomax was started.
next we took a turbohawk LSC atherectomy device. there was a total of 9 passes made along the distal left SFA into the popliteal trunk. Final angiography was performed with and without wire in place. the 90% lesion wwas reduced to less than 10%. I see no indications for stenting here, or balloon angioplasty. we did remove the long 7x45 terumo, and replaced it with a 7 short French sheath, into the right common femoral artery. patient left lab in stable condition with recommendation for a stage II procedure to the right distal superficial femoral artery to try to collect the CTO at a later date.
thanks
Beverly,CPC