Late presenting, contained rupture of the superficial femoral artery following atherectomy and stenting: case report and literature review.
Excisional atherectomy alone or followed by stenting is considered an appropriate treatment strategy for patients with lifestyle-limiting claudication due to obstructive infra-inguinal peripheral arterial disease (Ramaiah et al., J Endovasc Ther 2006;13:592-6021). We present a case of a 69-year-old man with eccentric severely calcified disease of the superficial femoral artery (SFA) treated with excisional atherectomy followed by stenting with an interwoven nitinol stent. The procedure was complicated by extravascular stent migration associated with a contained rupture presenting 30 days after the intervention. The complication was successfully treated with a stent graft. Although rare, pseudoaneurysms have been reported at the site of prior atherectomy; however, this case is the first description of a contained rupture post atherectomy associated with erosion of a nitinol stent into an extra-luminal position. The mechanism and management of this complication are discussed.
University of Colorado Hospital, University of Colorado, Denver, Aurora, Colorado.
Stacey
S
Clegg
Arash
A
Aghel
R Kevin
RK
Rogers
D000368:Aged; D000497:Alloys; D000800:Angioplasty, Balloon / Q000009:adverse effects* / Q000295:instrumentation*; D017073:Atherectomy / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000628:therapy*; D011474:Prosthesis Design; D011859:Radiography; D012421:Rupture; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D018084:Ultrasonography, Interventional; D061205:Vascular Calcification / Q000175:diagnosis / Q000628:therapy*; D057772:Vascular System Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery
D000497:Alloys; C013616:nitinol
atherectomy; contained rupture; pseudoaneurysm; superficial femoral artery