Lt. Iliac Artery Total Occlusion Angioplasty

- Operator : William A. Gray

Lt. Iliac Artery Total Occlusion Angioplasty
- Operator: Willam A. Gray, MD
Clinical Information

- Relevant clinical history and physical examination:
The patient was 60 years old man. He have been suffered from intermittent claudication in both Lt. buttock area.The symptom was not improved with optimal medical therapy and exercise therapy. We tried PTA at last year but failed (antegrade & retrograde approach). The claudication has not been improved. We decided to recanalize the occluded iliac artery.

- Relevant test results prior to catheterization:
The segmental limb pressure with ABI showed marked decreased ABI (0.68) from iliac level.

- Relevant catheterization findings:
Total occlusion with calcification was demonstrated at the Lt. iliac artery and moderate degree of stenosis at Rt. common iliac artery. (Figure 1)

Interventional Management

- Procedural step:
We approached both femoral routes with 7 Fr sheath insertion. Firstly, we checked aortography using 6 Fr Pigtail catheters. We used SIMMONS 5 Fr catheter with 0.032 inch Teflon wire. (Figure 2) A 0.035 inch terumo wire was passed into Lt. total lesion successfully. The wire was pulled into outside of lt. femoral sheath. He used hand-made dilator (cutted 5 Fr JR 4 catheter). (Figure 3) The 0.035 inch wire was changed into 0.032 inch Teflon wire. The lesion was dilated with POWERFLEX 5.0 X 40 mm before stenting. (Figure 4) The simultaneous Kissing stent technique was performed using PALMAZ CORNITHIAN 7.0 X 29 mm at Lt. side & PALMAZ CORNITHIAN 8.0 X 39 mm at Rt. side. (Figure 5) The final angiogram showed well-expanded and well-positioned stent. (Figure 6, Figure 7, Figure 8)

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