Antonio Micari

A 73-years old female with history of previous left carotid endarterectomy and recent acute transient ischemic attack was referred to our Center to undergo carotid stenting. Her Duplex ultrasound showed severe left internal carotid artery restenosis with significant Doppler flow acceleration.

This is a challenging case of a patient with severe claudication due to multi-level disease expanding from the common iliac up to the popliteal artery. The treatment includes the use of directional atherectomy for vessel preparation and DCB as antiproliferative therapy. The whole procedure is performed with CO2-angiography instead of contrast agent in order to avoid acute kidney injury. Learn also the best approach to treat patients with a multi-level disease, i.e. which lesion first.