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Case Sharing: A Case of Staged Revascularization of a Severe Three-Vessel Highly Calcified Lesion Complicated by Residual Sciatic Artery and Leg Atherosclerosis Obliterans
Dr. Taro Ichise, Fukui CardioVascular Center
Case Example
Male in his 80's
Chief complaint
Dyspnea
Medical history
Diabetes mellitus,
Chronic kidney disease,
Myelodysplastic Syndrome
Current medical history
The patient became aware of dyspnea and orthopnea around 18:00. His symptoms did not improve, and he was brought to the emergency room at 23:00.
History of PCI
X-11 PCI for LCX #11
→ BMS 3.0/15, 3.0/12
X-8 years PCI for LAD #6
→ DES 3.0/18
Medications
Clopidogrel 75mg,
Lansoprazole 30mg,
Nifedipine 20mg,
Doxazosin 8mg,
Tamsulosin 0.2mg,
isosorbide nitrate tape 40mg,
glimepiride 1mg,
Miglitol 150mg
Physical examination
Height 154cm, Weight 44kg
Body temperature 36.2°C
Blood pressure 155/65mmHg
Heart rate 92bpm
SpO2 91% (Room air)
Angry jugular vein
Listening for wheeze,
No heart murmur
Marked leg edema
Findings on admission
Mildly elevated myocardial deleterious enzymesElevated proBNPMild renal impai...
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