[MO-13] Presentation Awards
A case of successful PTA for long ilio-femoral occlusion after Fogarty embolectomy.
The patient is 71 year-old male, who has prior intervention history of Fogarty embolectomy for left superficial femoral artery (SFA) and percutaneous transluminal angioplasty (PTA) for left external iliac artery (EIA) and SFA due to re-occlusion after the Fogarty embolectomy. He presented with intermittent claudication and transient rest pain in his left leg, and we diagnosed it as re-occlusion of the left ilio-femoral artery. Angiography revealed that his left common iliac artery was occluded from just below the ostium. We performed PTA from the contralateral approach. Although wire crossing in CIA and EIA was relatively easy, wire manipulation in SFA was very difficult because of the organized thrombus and the contralateral approach. However, using IVUS guided wiring, IVUS knuckle technique, TruePath, and knuckle wire technique with 0.035” wire, we managed to reach to the vessel below the knee, and the route of the wire was in the true lumen for the most part. We placed Viabahn in the distal SFA, Zilver PTX in the proximal SFA, and Epic in the CIA, EIA, and CFA, and finally completed the procedure with good run-off. Three months later, we performed follow-up angiography when he admitted to our hospital due to another problem, and we found that the stent was patent and the vessels below the knee had become greater than the final angiography in the PTA procedure. We are going to report this successful PTA for the long ilio-femoral occlusion with some literature review.