Case

Both Femoro-Iliac Artery Stenosis Peripheral Angioplasty

- Operator : Seong-Wook Park

Both Femoro-Iliac Artery Stenosis Peripheral Angioplasty
- Operator: Seong-Wook Park, MD
Clinical Information

- Relevant clinical history and physical examination:
The patient was 74 years old man. He have been suffered from long-term (about 30 years) diabetes and hypertension. About 6 month ago, He complained intermittent claudication in both buttock area .The symptom was not improved with optimal medical therapy. So, he wanted for further evaluation and proper management.

- Relevant test results prior to catheterization:
The three dimensional CT angiogram showed short segmental stenoses of the proximal and distal EIA and distal SFA severe stenoses in Lt. extremity.

- Relevant catheterization findings:
Severe restenosis of right common iliac artery, left common iliac artery and distal SFA was revealed in peripheral angiopgraphy. (Figure 1, Figure 2)

Interventional Management

- Procedural step:
After Rt. femoral puncture, the 7Fr Angel sheath was inserted. The 0.032 inch Terumo wire was advanced into abdominal aorta, and then predilation with Powerflex 6.0 x 20mm was done. (Figure 3) The 0.018 inch (300cm length) Roadrunner guide wire was passed the lesion. Self expandable Zilver stent 8.0 x 60mm was deployed.(Figure 4) Using Rider 8.0 x 20mm balloon, the post-stent balloon dilatation was performed.(Figure 5) Using 6Fr JR4 catheter, we crossed the aorta bifurcation into left extremity. (Figure 6) After Rider 4.0 x 40mm balloon dilation, there was severe dissection in distal SFA lesion site. (Figure 7, Figure 8) So, We deployed self expandable Zilver 8.0 x 60mm stent. Using Powerflex 6.0 x 20mm balloon, post-stent dilation were performed. (Figure 9) The left CIA lesion was predilated with Powerflex 6.0 x 20mm balloon and then, self expandable SMART CONTROL 8.0 x 100mm stent was deployed in left CIA lesion. Using Rider 8.0 x 20mm balloon, the post-stent balloon dilation was performed.(Figure 10, Figure 11) The final angiography showed well-expandable stent in peripheral artery with good distal run-off. (Figure 12, Figure 13, Figure 14)

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