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60 y/o man, PAOD, DM, ESRD, already received Rt lower limb BKA for DM foot. Indication of angiography: Lt lower limb CLTI, Rutherford stage 5.
Left Lower Extremity PAOD Intervention — Tool List
Vascular Access
Sheath: 4Fr, 10cm（via Left Femoral Artery, micropuncture set）
Anesthesia
Local anesthesia: 2% Xylocaine, 8 mL
Guidewire
Gladius 0.014"
Procedure Stats
Fluoroscopy time: 14 minutes
Total procedure time: 45 minutes
Final TIMI flow: III ✅
Transcollateral
PAOD intervention
92 y/o man with hypertension and claudication worsening into toe ischemic ulcer. Lower limb CT angiography revealed Rt SFA total occlusion.
PTA to Rt SFA successful with 2.6 Fr CXI and Gladius 0.018-inch wire.
89 y/o man, ESRD, PAOD, with Rutherford stage 5 critical limb ischemia.
Toe gangrene developed after vasopressure use during shock treatment.
Successful retrograde puncture with ultrasound-guidance.
Lt ATA-dorsalis pedis artery pulses became detectable upon discharge. Planned with vascular Duplex at 1 month after procedure.
Contrast: 95 ml. Procedure time: 80 minutes.
PAOD case, s/p PTA to Rt SFA, successful,
70 y/o man, ESRD, CAD s/p PCI, claudication worsened to resting pain.
V18 wire with CXI 2.6 Fr.
82 y/o woman with Parkinsonism and embolic ALI in 2023-10.
PAOD, initially presented with acute limb ischemia, Rutherford stage 2A, received CDT in 2023-10.
Then received with Bokey and rivaroxaban 2.5 mg po bid.
After 2 months, the angio showed good flow in Lt SFA-PopA-TPT-PerA. And I tried to recanalize the Lt ATA with JR4 4 Fr and PT2 wire.
Success!
86-year-old man with claudication. PAOD diagnosed by Duplex.
Lt ATA total occlusion, TPT-PerA critical stenosis.
Successful PTA with wiring: Gladius, Astato 20/CXI 2.3 Fr.
71 y/o man,
Intra-abdominal abscess, septic shock, with acute limb ischemia Rt lower limb gangrene s/p Rt lower limb amputation.
A case with typical poly-vascular disease (multi-site artery disease).
Systolic heart failure, atrial fibrillation, and poor waveform in Lt lower limb.
Revascularization with DES to LAD and Lt SFA total occlusion recanalization in 120 minutes. Total contrast 80 ml.
Ref: 2021-09-13.
