Abstract
Endovascular stent placement is taking place of the bypass surgery in patients with peripheral arterial disease, over the last decade. However, patency of the long segment stents, below knee disease, advenced age, absence of distal runoff, diabetes and chronic renal disease are still challenging. Surgical bypass for the superficial femoral artery occlusive disease to the below the knee stenosis by using autologous vein graft has still good results. Here we present a 55 year old male who had long segment superficial femoral artery atherosclerotic disease. He had a history of long segment endovascular stent placement. We extracted the restenotic stent and performed bypass with PTFE graft to the below the knee.
Highlights
Endovascular stent placement has an important role for the treatment of the patients with peripheral arterial disease especially with the superficial femoral artery occlusive disease, in recent years
Bypass was performed between the common femoral artery and the above and below the knee poplieal artery and to the posterior tibial artery with 8 mm PTFE graft due to lack of saphenous vein graft
Myointimal hyperplasia usually occurs in the transition zone between stent and the artery
Summary
Endovascular stent placement has an important role for the treatment of the patients with peripheral arterial disease especially with the superficial femoral artery occlusive disease, in recent years. Treatment of excessive long segment superficial femoral artery stenosis is still controversial and reduces the patency [2]. Stents are more prone to external compression especially during flexion of the hip and the knee. Thrombosis, implantation technique, intimal dissection, negative remodeling, intimal hyperplasia, stent fracture are reducing the success rate of the stent placement.
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