Slides Endovascular Peripheral Disease Iliac
A Case of Complete Salvage of Critical Limb Ischemia with Total Occlusion from Common Iliac Artery to Superficial Femoral Artery
- Operator : Hiroaki Fujie
A Case of Complete Salvage of Critical Limb Ischemia with Total Occlusion from Common Iliac Artery to Superficial Femoral Artery |
- Operator: Hiroaki Fujie, MD |
Clinical Information |
82-year old gentleman with dyslipidemia was admitted to our hospital with sudden-onset significant left below-knee cyanosis combined with ulceration and infection at left 3rd and 4th toes which showed gangrenous changes (Figure 1, Figure 2). Laboratory tests on admission were as follows ; WBC 8600/¥ìl, CRP 5.1mg/dl, CPK 632U/I. MR angiography showed total occlusion of left CIA ostium with multiple bridge collateral, so we decided to perform emergency angiography. |
Baseline Catheterization Findings |
The emergent peripheral angiography showed total occlusion of left CIA to CFA, and diffuse long SFA CTO lesion, in which partially revealed true lumen by multiple collateral flow ( |
Procedure |
Left CIA was cannulated with a 6Fr IMA guiding catheter with side hole through right femoral approach. We tried antegrade approach at CIA ostium by using a 0.014 inch Cruise with Transit2 135cm microcatheter (Figure 3). After negotiation, pre-dilation was performed with Jackal OTW 3.0-100mm through left CFA (Figure 4). First target was left CIA lesion. However, tip injection from microcatheter showed that deep femoral arterial flow was very weak ( |
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