Peripheral artery disease: Contemporary approach through case report

Introduction. Peripheral arterial disease (PAD) of the lower extremities is an atherosclerotic disease of the arteries of the legs. Due to the frequent overlap of PAD and ischemic heart disease, cardiologists are in a unique position to screen, diagnose, and treat PAD. The aim of the paper is to present the initial results of the Department of Invasive Cardiology of Health center Zaječar in the diagnosis and treatment of patients with PAD of the lower extremities. We present the initial results of the Department of Invasive Cardiology, including screening, noninvasive and invasive (angiographic) diagnosis of PAD of the lower extremities. Starting from March 2020, the Department of Invasive Cardiology is performing diagnostic invasive peripheral angiography in patients selected by non-invasive diagnostics from the territory of Eastern Serbia. In 2020 there were 3 and in 2021 5 more invasive peripheral angiographies performed. The number of these procedures is gradually increasing and during the first 10 months of 2022, 10 peripheral angiographies were performed. A total of 6 percutaneous angioplasties were performed as part of the endovascular treatment of PAD of the lower extremities, two of them within the Department of Invasive Cardiology Health center Zaječar symposium - ZASINK 2021. A complex patient with numerous comorbidities who was successfully treated with percutaneous angioplasty in our center is also presented. Case report. A 67-year-old female patient with intermittent claudication at a distance of less than 10 meters after a physical examination was referred to ABI, which indicated a hemodynamically significant disease of the left leg (1.02 right; 0.68 left). Peripheral angiography was performed, which showed short segment stenosis of the left common iliac artery of about 80% and endovascular treatment was planned for the second act. During the following angiography, the mentioned segment was occluded. Percutaneous angioplasty was performed with the implantation of two balloonexpandable bare metal stents, with an excellent immediate angiographic result. After the procedure, the patient had significant symptomatic improvement. Dual antiplatelet therapy was continued for 6 months. During the follow-up period of 8 months, there were no clinically significant events in the patient. Conclusion. In a health center with experience in the treatment of various forms of coronary artery disease, the diagnosis and treatment of patients with PAD of the lower extremities can be successfully done with low procedural risk, as shown by our experience with 17 peripheral angiographies and 6 peripheral angioplasties performed, with a tendency to further increase the number and complexity of procedures performed.