How should we manage thrombosis of Viabahn stent-graft? A case report focused on catheter-directed thrombolysis

Won Yu Kang, Umberto Campia, Nelson Lim Bernardo, Romain J. Didier, Smita I. Negi, Sarkis Kiramijyan, Edward Koifman, Nevin C. Baker, Michael J. Lipinski, Ricardo O. Escarcega, Rebecca Torguson, Ron Waksman

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To report a case of a thrombosed GORE® VIABAHN® endoprosthesis stent-graft in the femoral artery (SFA) and popliteal artery managed using the pulse-spray technique and complicated by compartment syndrome of the lower leg of the affected limb. Case Report: A 61-year-old woman with three Viabahn stent grafts relining seven bare-metal stents in her right SFA and popliteal artery visited our hospital with complaint of recurrent lifestyle-limiting claudication of right leg. Angiography and intravascular ultrasound showed complete intra-stent obstruction by thrombus from the proximal right SFA to the proximal popliteal artery. Catheter-directed thrombolysis using pulse-spray technique followed by mechanical thrombectomy was performed. Despite successful recanalization, unfortunately, compartment syndrome developed on her right leg on the following day and fasciotomy was performed. Conclusion: The larger thrombus burden in Viabahn stent-grafts and its unique physicochemical properties increases the risk for distal embolic complications and potential poor clinical outcomes.

Original languageEnglish
Pages (from-to)134-137
Number of pages4
JournalCardiovascular Revascularization Medicine
Volume17
Issue number2
DOIs
StatePublished - 1 Mar 2016
Externally publishedYes

Keywords

  • Compartment syndrome
  • Thrombolysis
  • Thrombosis
  • Viabahn stent-graft

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