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1、Session VI|Superficial Femoral Artery Disease:Femoropopliteal Phase 4Friday,September 12,20253:52PM-4:22PMLive Case Presentation#5 Pradeep K.Nair,MD,FACC,FSCAIInterventional CardiologistCardiovascular Institute of the SouthAmbulatory Surgery CenterGray,LouisianaDisclosures Advisory Board:Philips,Cor

2、dis Consultant:Philips,Nipro,BARD,Asahi Speakers Bureau:Abbott,Philips,Surmodics,Reflow Medical Research:Aveera,MercatorCase History HPI:67-year-old former smoking male with PMH PAD,HTN,dyslipidemia,and CAD presents with nonhealing ulcer to left hallux(Rutherford 5).SocHx:Quit smoking 2023-2024(1/2p

3、pd x 40 years)Pertinent Meds:rivaroxaban 2.5mg PO BID,clopidogrel 75mg PO QD,atorvastatin 40mg PO QHS,amlodipine 5mg PO QD,Imdur 30mg PO QDPMH:PAD with h/o CLTI 2023-2024CAD Ca score 1344DyslipidemiaHTNCOPDColon Cancer with Liver Mets-(chemo/partial colectomy and liver resection 2023)Basal Cell CA s

4、/p resectionCLTI Presentation February 2024 Non-healing hallux ulcer developed in 2023 during his cancer treatments.Rutherford 3 claudication was reported for 1-2 years prior.SFA occluded,PT diffusely diseased.CART re-entry distal SFA 6x150mm Supera placed distal SFA Ranger DCB 7x200mm to proximal S

5、FA PTA Posterior Tibial Wound healed 2 months laterFebruary 2024 InterventionFebruary 2024 Intervention6x120mm SuperaMay to July 2025 May 2025:Claudication progressed from Rutherford 2 to 3.Pain after 50-100 feet of walking.ABI 0.54 left,Duplex US SFA re-occluded Sent for monitored exercise program

6、and initiated cilostazol 100mg PO BID Cilostazol stopped for nausea one week after initiating.Claudication improved marginally with walking program x 6 weeksAugust to September 2025 September developed new ulcer to left hallux(Rutherford 5)

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根据报告的内容,全文主要内容概括如下: - **患者信息**:67岁男性,有既往病史,包括PAD、CAD、高血压、高血脂、COPD、结肠癌肝转移等。 - **病情发展**:2023年出现左足大拇指溃疡(Rutherford 5级),2024年进行血管重建手术,但2025年病情恶化,出现跛行和新的溃疡。 - **干预措施**:2025年9月,患者出现新的溃疡,左ABI为0.46。 - **干预计划**:使用影像引导技术优化再血管化,确定原位狭窄和ISR的管理策略,评估是否需要腘下再血管化。 核心数据: - Rutherford分级:5级 - ABI:0.54(左腿) - Ca score:1344 - 血管重建手术:2024年进行,包括放置Supera支架和Ranger DCB球囊扩张。
病例解析" "如何优化下肢动脉疾病治疗?" 动脉闭塞症干预策略"
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