Multi-Level Endovascular Intervention for Severe Peripheral Arterial Disease: A Case Report and Literature Review
Peripheral arterial disease (PAD) is a progressive atherosclerotic condition that may involve multilevel arterial segments and often coexists with aneurysmal disease. We report the case of a 78-year-old male with extensive cardiovascular comorbidities who underwent staged multilevel endovascular revascularization of the tibial and femoropopliteal segments for severe PAD with concomitant aneurysmal disease. Following abnormal vascular imaging during preoperative cardiac clearance, he underwent right tibial and tibioperoneal trunk angioplasty followed by left femoral-popliteal aneurysm repair and stenting. Postoperative recovery was uneventful apart from transient acute kidney injury. This case illustrates the diagnostic and therapeutic challenges of complex PAD, highlights the evolving role of multilevel endovascular interventions, and contextualizes decision-making with current evidence and guidelines.