69 year old female with Rutherford class V, nonsmoker, CAD, LAD PCI with RCA CTO, DM Type 2, Hyperlipidemia, HTN, PAD with prior bilateral CIA stents and right fem-pop known to be occluded. Performing physicians: Mena/Huynh - Full Case

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Full Description: 

Case #1:
Performing physicians: Mena/Huynh
69-year-old female with Rutherford class 5, non-smoker, CAD, LAD PCI with RCA CTO, DM Type II, hyperlipidemia, HTN, PAD with prior bilateral CIA stents and right fem-pop known to be occluded,
Physical exam: Non-healing ulcer on her foot.
Diagnostics:
• Pre-procedure ABI: R 0.3; L 0.78
• CTA: Abnormal suggesting R SFA occlusion with occluded fem-pop:
• Angiogram: Bilateral CIA stents patent, EIA and CFA bilaterally patent. On the R leg: occluded fem-pop as well as native SFA with reconstitution of her pop through collaterals from profunda, two-vessel run-off
Plan:
• Contralateral access
• Use CROSSER
• If subintimal, use re-entry device
• PTA if subintimal stent

Goal:
• CLI therapy for patient with long CTOs
• Use of crossing device
• Use and understanding of re-entry device
• PTA/stent techniques

Facility Name: 
Presenter Name: 

Carlos Mena, MD, FACC, FSCAI

Presenter Title: 

Assistant Professor, Department of Internal Medicine

Section of Cardiovascular Medicine, Yale University of Medicine

Medical Director Vascular Medicine

Yale-New Haven Hospital