True lumen re-entry after extravascular recanalization of a superficial femoral artery chronic total occlusion.
A 66-year-old man was treated for disabling right leg calf claudication with angioplasty and stenting of a chronically occluded superficial femoral artery. During attempted subintimal passage, the guidewire tracked extralumenally, which was not recognized, but it was successfully redirected into the true lumen distal to the occlusion with the use of the Outback (Cordis Endovascular, Miami Lakes, Fla) re-entry device. A bare metal nitinol stent was initially deployed extralumenally in the perivascular soft tissue. The patient returned for reintervention 9 days later complaining of pain and discoloration of the popliteal space. Duplex evaluation of the superficial femoral artery revealed a pseudoaneurysm, and Viabahn stent grafts (W. L. Gore & Assoc, Flagstaff, Ariz) were successfully deployed to produce an endovascular percutaneous prosthetic bypass.
Wagner
Jason K
JK
Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Chaer
Rabih A
RA
Rhee
Robert Y
RY
Marone
Luke K
LK
D000368:Aged; D000497:Alloys; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D002908:Chronic Disease; D003251:Constriction, Pathologic; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000628:therapy; D008297:Male; D011474:Prosthesis Design; D015607:Stents; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
D000497:Alloys; C013616:nitinol