Unusual cause of acute limb ischemia – stent fracture


Authors: J. C. M. Lubanda
Published in: Kardiol Rev Int Med 2010, 12(4): 179-180
Category: Angiological Symposium

Overview

We report a case of an 81 year old man who was treated for recurrent acute limb ischemia of the right leg. The patient had a prosthetic femoropopliteal bypass inserted 25 years ago. This reconstruction was replaced with a new prosthetic bypass 10 years later. The patient was readmitted for acute limb ischemia in May 2006. Because of several comorbidities at that time, surgery was not possible and endovascular treatment was undertaken with rheolytic thrombectomy and angioplasty with bailout stenting of the distal anastomosis of the femoropopliteal bypass. Two years after this intervention, the patient presented with acute limb ischemia due to reocclusion of the femoropopliteal bypass. He was then treated with catheter directed local thrombolysis and a stent fracture was found in the distal anastomosis of the bypass. This was the primary cause of the reocclusion of the bypass. According to current practice, stent implantation in prosthetic femoropopliteal bypasses should be avoided, if possible, and a surgery is the strategy of choice. Bailout stenting in this specific location should be reserved for such cases when the surgery is not feasible and limb salvage is required.

Keywords:
acute limb ischemia – stent fracture – femoropopliteal bypass


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Labels
Paediatric cardiology Cardiac surgery Cardiology
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