Annals of Vascular Surgery - Brief Reports and Innovations (Dec 2024)
A case report of superficial femoral artery pseudoaneurysm caused by stent fracture
Abstract
Purpose: Developing pseudoaneurysms following stent fracture is a rare complication of stent implantation in patients with chronic lower limb ischemia. We presented a case of pseudoaneurysm secondary to a femoral artery stenting fracture in the left lower extremity, which was successfully managed with vascular intervention under local anesthesia and followed up for 36 months. Case Report: An 80-year-old male with a history of hypertension and cerebral infarction presented with a mass in the left lower limb accompanied by swelling and pain. Doppler ultrasound revealed a pseudoaneurysm measuring 6 × 7 cm in the left superficial femoral artery. Subsequent digital subtraction angiography indicated a fracture of the original stent overlap and a ruptured pseudoaneurysm measuring 8 cm in diameter. Following intravenous heparin administration, a 7 × 150 mm self-expanding membrane-covered stent was successfully implanted to address this issue. Final angiography confirmed proper stent placement, exclusion of the aneurysm, and absence of internal leakage. No obstruction was observed in the sub patellar artery. The patient's symptoms gradually improved without requiring further surgical intervention. Oral aspirin and clopidogrel were administered for 36 months after surgery, and there was no recurrence of symptoms. Conclusion: Active surgical intervention is the optimal treatment approach for patients with pseudoaneurysm caused by stent fracture, whereas endovascular therapy remains a dependable option for such scenarios. The crucial step in the procedure involved inserting the guidewire into both ends of the fractured stent to establish the operative pathway, followed by the introduction of the self-expanding covered stent and isolation of the aneurysm. This endeavor aimed to offer significant insights for treating similar conditions.
