Successful outside-the-stent stenting for an occluded primary stented superficial femoral artery
- PDF / 538,016 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 20 Downloads / 183 Views
CASE REPORT
Successful outside-the-stent stenting for an occluded primary stented superficial femoral artery Akihiro Nakamura • Sota Nakajima • Hideaki Endo • Tohru Takahashi • Eiji Nozaki
Received: 5 August 2013 / Accepted: 23 September 2013 Ó Japanese Association of Cardiovascular Intervention and Therapeutics 2013
Abstract A 61-year-old man with in-stent occlusion of the superficial femoral artery (SFA) underwent the endovascular therapy using a subintimal technique. The wire was intentionally advanced into the subintimal space next to the occluded stent in the SFA, and a stent was implanted in a double barrel fashion outside of the in-stent occlusion site. The procedure was performed without any complications and with the successful angiographic and intravascular ultrasound imaging results. At 1-year follow-up, the patient still had no leg complaints and the stent was still shown as patent. The procedure might be a useful technique when the recanalization was proved impossible after several attempts to recanalize the primary occluded stent in the SFA. Keywords Superficial femoral artery Stent restenosis Subintima Stenting Introduction Stent restenosis is one of frequent complications of endovascular therapy (EVT) for the superficial femoral artery (SFA) [1]. The conservative therapy and recanalization by EVT or surgical intervention are available therapeutic methods for this complication. For the reason of the less invasive therapy, endovascular reintervention was often performed for recanalization of the occluded stent placed in the SFA. However, passage of wire or balloon through the occluded stent is not possible in some cases. A. Nakamura (&) S. Nakajima H. Endo T. Takahashi E. Nozaki Department of Cardiology, Iwate Prefectural Central Hospital, 1-4-1 Ueda, Morioka, Iwate 020-0096, Japan e-mail: [email protected]
We experienced a case of failed recanalization using conventional wire technique for in-stent occlusion of the SFA, and consequently treated it with a stent implanted outside of the in-stent occlusion site using a subintimal technique. To our knowledge, there have been few reports that describe stent implantation outside of a prior stent in a case resulting from in-stent occlusion of the SFA. We report here our experience with a treatment strategy for instent occlusion in the SFA when the wire could not pass the occlusion site within a previously implanted stent.
Case presentation In October 2011, a 61-year-old man with hypertension, diabetes mellitus, and former tobacco use was admitted in our hospital for a two-year history of progressive lateral calf Rutherford-Becker class 3 intermittent claudication (IC) despite medication optimization. The patient’s maximum walking distance was about 100 m, and the anklebrachial index (ABI) at rest was 0.53 for the right leg with monophasic wave forms. Angiography revealed occlusion of the right superficial femoral artery (SFA) from its ostium with collaterals supplying the distal portion of the SFA. EVT was performed by a cros
Data Loading...
