TCTAP C-186 One-stage Endovascular Treatment for Complicated Peripheral Arterial Occlusive Disease with Multiple Segmental Lesions

Clinical Information Patient Initials or Identifier Number Mr. S.Relevant Clinical History and Physical Exam A 44-year-old man with underlying diseases with CAD (2-V-D), Type 2 DM, Hypertension and End-stage renal disease on regular hemodialysis. Very weak left femoral artery and popliteal artery pulsation and no dorsalis pedis pulse.Relevant Test Results Prior to Catheterization Ankle-Brachial Index (ABI) performed before intervention showed right side 0.53 and left side unmeasured.Relevant Catheterization Findings Before intervention, catheterization finding showed; [...]we got a good flow of both common iliac artery, left SFA and distal runoff of left foot.Conclusions ▶ For cases with complicated and multi-segment lesions PAOD. → Interventionist should be familiar with the antegrade and retrograde approach technique. ▶ Sometimes multi-stage EVT is needed for the complicated case; however, if we can combine antegrade and retrograde technique for these complicated case. → We may shorten multi-stage EVT to even one-stage EVT which can decrease the tissue necrosis territory and even further limb salvage. ▶ Safety is still the first priority for this high risk and complicated case. → Balloon hemostasis is a useful method for retrograde puncture and avoid & decrease the complication rate such as hematoma.