Korean Circ J.  2015 Nov;45(6):522-525. 10.4070/kcj.2015.45.6.522.

Femoropopliteal Artery Stent Fracture with Recurrent In-Stent Reocclusion and Aneurysm Formation: Successful Treatment with Self-Expandable Viabahn Endoprosthesis

• Lee YJ
• Shin DH
• Kim JS
• Kim BK
• Ko YG
• Hong MK
• Jang Y
• Choi D

• KMID: 2223792
• DOI: http://doi.org/10.4070/kcj.2015.45.6.522

Abstract

Primary stenting in femoropopliteal lesions of intermediate length has recently shown favorable outcomes. However, stent fractures are a concern after bare metal stent implantation. The incidence of stent fracture varies widely (ranging from 2% to 65%) depending on factors such as the treated lesions or stent type and may potentially lead to various complications. We reported a case of stent fracture with complete dislocation combined with recurrent in-stent reocclusion and aneurysm formation in a patient with occlusive disease of the femoropopliteal artery, which was successfully treated with self-expandable endovascular stent graft.

Keyword

Blood vessel prosthesis; Graft occlusion, vascular; Aneurysm, false

MeSH Terms

Aneurysm*
Aneurysm, False
Arteries*
Blood Vessel Prosthesis
Dislocations
Graft Occlusion, Vascular
Humans
Incidence
Stents*

Figure

• 

  Fig. 1 Initial and follow-up angiography at 7 months and 13 months. (A) Initial angiography shows total occlusion of distal femoral artery extending to popliteal artery. (B) Balloon angioplasty with stent implantation (white arrows) is performed. (C) At 3 months, previous stent maintained patency without aneurysmal changes. (D-E) At 7 months, multiple tiny fractures (type II) (arrow heads) are noted. Angiography reveals 30% neointimal hyperplasia at proximal portion (black arrow) with aneurysmal change at mid to distal portion of stent. (F) At 13 months, total occlusion of prior stent is noted with severe claudication.

• 

  Fig. 2 Follow-up computed tomography (CT) and angiography at 2 years (A) CT angiography shows total destruction in middle part of the prior stent with aneurysmal changes around the fractured stents. (B) Stent fracture (type V) with complete dislocation is noted. (C) Angiography reveals total occlusion of left distal femoral stent. (D) A 7.0×150 mm self-expandable Viabahn stent (W.L. Gore & Associates, Flagstaff, Ariz, USA) is deployed. (E) Final angiogram shows no residual stenosis with complete exclusion of the pseudoaneurysm.

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