Abstract
A 59-year-old man with critical claudication underwent left femoro-anterior bypass grafting, which was uneventful. The graft was tunneled medially across the knee, then anterior to the tibia. His symptoms recurred 1 year later and he was found to have critical stenosis of the vein graft just proximal to the anterior tibial arterial anastomosis. This was treated with scaffolded balloon angioplasty and implantation of a coronary, zotarolimus-eluting balloon-expandable stent, which was also uneventful. However, his claudication again recurred 1 year later. Diagnostic angiography revealed crush, deformation and restenosis of the balloon-expandable stent requiring surgical revision of the bypass graft.
Keywords:
crush deformation of intravascular stent; endovascular stenting; stent deformation; vein graft stenosis; vein graft stent.
MeSH terms
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Angioplasty, Balloon / adverse effects
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Angioplasty, Balloon / instrumentation*
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Cardiovascular Agents / administration & dosage*
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Computed Tomography Angiography
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Critical Illness
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Drug-Eluting Stents*
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Graft Occlusion, Vascular / diagnostic imaging
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Graft Occlusion, Vascular / etiology
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Graft Occlusion, Vascular / physiopathology
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Graft Occlusion, Vascular / therapy*
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Humans
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Intermittent Claudication / surgery*
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Male
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Middle Aged
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Peripheral Arterial Disease / surgery*
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Prosthesis Design
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Prosthesis Failure*
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Recurrence
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Reoperation
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Saphenous Vein / diagnostic imaging
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Saphenous Vein / physiopathology
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Saphenous Vein / surgery*
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Sirolimus / administration & dosage
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Sirolimus / analogs & derivatives*
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Time Factors
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Treatment Outcome
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Ultrasonography, Doppler, Duplex
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Vascular Grafting / adverse effects
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Vascular Grafting / instrumentation*
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Vascular Patency
Substances
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Cardiovascular Agents
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zotarolimus
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Sirolimus