Abstract
This case illustrates one of the worst technical complications that can occur in a peripheral endovascular procedure with stent grafts. The study was approved by our institutional review board. Informed consent of patient was waived. Treatment of a popliteal fusiform aneurysm with two overlapping GORE VIABAHN stent grafts (W.L. Gore & Associates, Inc, Flagstaff, Arizona) was planned. Digital subtraction angiography showed a fusiform aneurysm 15 cm long with a 2.5-cm diameter extending from the mid– superficial femoral artery to the initial popliteal-P3 segment (Fig 1). The stent grafts (6and 7-mm-diameter, 10-mm-long devices) were placed from distal to proximal with a 3-cm overlap, covering the length of the aneurysm. A final angiogram was obtained after placement of the stent grafts and showed slow flow and delayed contrast opacification indicating that the stent grafts were not coaxially overlapped (Fig 2). The distal guide wire was positioned lateral to the distal stent graft (arrow in Fig 2). Inattention led to
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