Dr Abadir Critical Limb Ischemia Case
Dr. A. Ramsey Abadir is board certified by the American Board of Radiology in Diagnostic Radiology, with a certificate of added qualification in Vascular & Interventional Radiology.
Patient History and Consultation
82 year-old male with painful blistering ulcerations on the anterior surface of the left lower leg progressively worsening over 4 months despite wound care. Pt also complains of “tiredness” in the left leg on ambulation. No distal pulses palpable. History of stent placement in left leg.
Past Medical History
- Coronary Artery Disease s/p CABG and coronary stents
- Atrial fibrillation
- Prior smoker
The patient started with a Preliminary Evaluation
- Lab evaluation: Lipids
- Start Statin Therapy
- Discuss with cardiology re: changing from Coumadin to antiplatelet therapy
- Arterial duplex:
Diffuse disease with 75% stenosis of proximal SFA, occluded Anterior Tibial artery and slow monophasic flow in Posterior Tibial and Peroneal Artery
Angiography with angioplasty/atherectomy and stent as needed.
(Image above –Proximal SFA stenosis treated with atherectomy and angioplasty)
(Image above – Occluded ATA and poor collateralization)
(Image above – Post atherectomy and angioplasty and Restored patency of AT)
(Image above – Wounds have progressively healed and Pain in leg significantly improved)
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