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Home Management of Iliac Artery Occlusive Disease

Variants

Adult. Worsening claudication and small ischemic ulcers on digits of both feet. CTA demonstrates diffuse atherosclerosis involving distal aorta and both common and external iliac arteries with multiple stenoses at or greater than 50%, bilateral mid-superficial femoral artery stenoses at or greater than 70% with 2-vessel tibial runoff bilaterally (TASC D). Initial therapy.

Documents

Scenario

Scenario ID

Procedure

Adult RRL

Peds RRL

Appropriateness Category

Adult. Worsening claudication and small ischemic ulcers on digits of both feet. CTA demonstrates diffuse atherosclerosis involving distal aorta and both common and external iliac arteries with multiple stenoses at or greater than 50%, bilateral mid-superficial femoral artery stenoses at or greater than 70% with 2-vessel tibial runoff bilaterally (TASC D). Initial therapy.

3198467

Hybrid revascularization with endovascular stenting of aortoiliac disease and infrainguinal bypass

Usually appropriate

Percutaneous stent placement aortoiliac arterial segment plus superficial femoral

Usually appropriate

Antiplatelet adjunctive therapy

Usually appropriate

Surgical revascularization

Usually appropriate

Percutaneous stent placement aortoiliac arterial segment

May be appropriate

Anticoagulation adjunctive therapy

May be appropriate

Best medical management including supervised exercise program only

Usually not appropriate

Percutaneous transluminal angioplasty aortoiliac arterial segment

Usually not appropriate