Fracture of a Covered Stent Used for Pseudoaneurysm Exclusion in a Prosthetic Femoro-Infrapopliteal Bypass

Purpose: To present a case of fracture in a stent-graft used for exclusion of a pseudoaneurysm in a prosthetic femoro-infrapopliteal bypass. Case Report: A Hemobahn stent-graft was inserted into a Dacron femoro-infrapopliteal bypass to avoid repeat surgery for a recurrent distal anastomotic pseudoaneurysm that had been excluded 2 years earlier by a Dacron interposition graft in a 69-year-old woman. Three months after stent-graft implantation, the patient complained of pain around the left knee; plain radiography showed stent fractures at 2 sites coinciding with the proximal and distal anastomoses of the interposition graft, and ultrasonography detected a new pseudoaneurysm at the distal anastomosis. The stent-graft was explanted and the pseudoaneurysm excluded with a new interposition graft. Conclusion: Although some stents have high flexibility and radial strength that make them suitable for use in periarticular vessels, interventionists should take into account the possibility of stent fracture when weighing the treatment options.