CLINICAL CASE 1 (VIL):72 yar old woman with intermittent claudication right>left. Past medical history significant for prior PTA of right SFA/POP arteries.

CTA 09-SEP:• focal narrowing of infrarenal aorta (non-calcified plaque)LEFT:• mild and moderate diffuse disease of left SFA• tibio-peroneal trunk and PTA disease, PER occlusionRIGHT: •diffuse disease in right SFA with focal dissection in distal SFA/POP artery which results in a high-grade stenosis.•mild to moderate focal stenosis of ATA origin. PTA and PER arteries are occluded

Treatment plan:percutanous angioplasty/stent of right femoropopliteal artery.

DSA / PTA 10-SEPBallon angioplasty (5mm/8cm) and stent placement (6mm/10cm) in dissected segment.

MIP

ANGIOVIS 2007CLINICAL CASESANGIOVIS 2007CLINICAL CASES

CASE 1 (continued)

Mul

tiPat

h-C

PR;

thin

, str

etch

ed (c

lose

-up,

w ri

ght l

eg s

how

n on

ly)

DSA

Mul

tiPat

h-C

PR;

thin

, str

etch

ed

CLINICAL CASE 2 (WAE):73 yar old woman with intermittent claudication bilaterally

CTA 14-OCT:• mildly ectatic CIA bilaterallyLEFT:• diffuse disease w mult dilatations and stenosis of left EIA • diffusely diseases left SFA• short (2cm) sub-total occlusion of distal fem/pop segment.RIGHT: • SFA occlusion (>20cm)

Treatment plan:percutanous angioplasty/stent left ext.iliac and fem-pop arteryconsider surgical revscularization of right lower extrmity (fem-pop bypass).

DSA / PTA 15-OCT:Ballon angioplasty (8mm/4cm) and stent-PTA (10mm/6cm) left EIA, recanalization and PTA (4mm/4cm) of left fem-pop a.

MIP

Case 2 (continued)

Mul

tiPat

h-C

PR;

3mm

thi

ck, p

roje

cted

DSAThi

nCPR

Left,

str

etch

ed

post PTA

post PTA /stent

CLINICAL CASE 3 (HAH):59 yar old man with intermittent claudication bilaterally.Past medical history significant for prior Stent-PTA of right EIA.

CTA 25-OCT:AORTA/ILIAC: • Extensively calcified plaque within the distal aorta, extending into the left CIA with significant aortoiliac stenosis. • The right EIA stent is patent, however, there is a small shell of calcium obstructing the proximal end of the stent.LEFT: • long SFA occlusion w. numerous collaterals.RIGHT: • long SFA occlusion w. numerous collaterals.

Treatment plan: Percutaneous treatment of inflow disease.

DSA / PTA 27-OCTBallon angioplasty and "kissing" stent placement in bilaterl aortoiliacarteries (10mm/4cm and 10mm/6cm), stent PTA of right EIA (10 mm/3cm).

MIP

Case 3 (continued)

MultiPath-CPR; thin, stretched

DSA

ThinCPRRight, stretched

post

ki

ssin

g st

ent

pre-

PTA

/re-s

tent

of

sten

t-ste

nosi

s

MultiPath-CPR; thin, stretched, close-up

CLINICAL CASE 4 (ALF):81 year old woman with PAOD (Fontain stage IV) of right lower extremity. Past medical history significant for prior above-knee amputation of left lower extremity.CTA 20-DEC:Maximum intensity projeced (MIP) and thin, stretched curved planar reformation (CPR) through the right popliteal artery demonstrate a high-grade (99%) stenosis with collaterals in the supragenual poplitea segment.

DSA / PTA 21-DECSelective DSA, performed on the following day (with guide-wire in place), shows a 5cm occlusion (caused by the guide-wire passing through the high-grade stenosis), which is treated by balloon angioplasty (4mm/8cm).

MIP

MIP

Thin

CPR

Rig

htst

retc

hed

DSADSA PTA (4mm/8cm)PTA (4mm/8cm)

Case 4 (continued)

Mul

tiPat

h-C

PR;

thin

, str

etch

ed