Overview
Dr. Syed Rizvi used the JADE® PTA Balloon and Diamondback 360® Peripheral Orbital Atherectomy System via radial artery access to successfully treat the right lower extremity.
Dr. Syed Rizvi used the JADE® PTA Balloon and Diamondback 360® Peripheral Orbital Atherectomy System via radial artery access to successfully treat the right lower extremity.
A 73-year-old male presented with a slow healing wound on his right fifth toe and complained of rest pain, cramping in the foot and calf while walking, and a previous slow healing ulcer on his heel. The patient noted the right leg symptoms feel the same as the left did prior to receiving treatment.
The patient has a history of left leg endovascular repair to the left mid superficial femoral artery and a previous left heart catheterization with a drug-eluting stent.
A duplex ultrasound showed a plaque buildup of 50-60% in the right common femoral artery and 60-70% plaque in the proximal-mid superficial femoral artery (SFA). The peripheral artery disease in the right leg was categorized as Rutherford Class 5.
The patient’s risk factors include calcium risk factors due to diabetes, as well as hypertension and hyperlipidemia. He is also a smoker.
After consulting with Dr. Rizvi, the patient elected for a radial access approach due to a less than desirable experience with a previous groin access complication. Radial access used a 119 cm sheath. Runoff to the right leg was achieved using a pigtail catheter. Several severe calcifications were noted in the mid-SFA. Three vessel runoff was noted below the knee. One of the calcified nodules noted prevented proper contrast from reaching the runoff in the right leg.
Due to the size of the SFA, Dr. Rizvi selected the Diamondback 360 Peripheral Orbital Atherectomy System with a 1.75 mm Solid Crown. Using the Diamondback 360, he performed four passes at low and medium speeds and a pass at high speed. Afterward, he determined that another high-speed pass was needed for optimal outcomes.
Dr. Rizvi then decided to use a 6mm x 150mm JADE PTA Balloon via the existing radial access. He inflated the balloon at 8 atmospheres, at which point the lesion gave way, and maintained inflation for two minutes which he determined was sufficient for the desired result.
The post-treatment angiogram showed no flow limiting dissections, and that post-intervention runoff was brisker than before the treatment. The patient tolerated the procedure well and, with no complications, was discharged within three hours after the sheath had been removed.
Results may vary.
Suggestions on case studies offered by the physician are based on their experience using the Diamondback 360® Orbital Atherectomy System and the JADE® PTA Balloon and are their opinion. Medical decisions for your patients are to be based upon their condition and your medical judgment. CSI does not recommend or endorse any particular course of treatment or medical choice. Before using any medical device, including those demonstrated or referenced in this case study, review all relevant Instructions for Use, with particular attention to the indications, contraindications, warnings and precautions, and steps for use of the device.