Stent fracture as a complication of superficial femoral artery stenting – a case report

Jędrzej Tkaczyk, Michał Terpiłowski, Klaudia Brożyna, Katarzyna Baltaziak, Barbara Klatka, Jan Jakub Kęsik, Marek Iłżecki


Introduction: Peripheral artery disease (PAD) is an atherosclerotic vascular disease that results in obstruction of blood flow in the arteries other than those in the coronary circulation. PAD is often located in lower extremities, with patients presenting symptoms of intermittent claudication or critical lower limb ischemia. Angioplasty and stent implantation are often used in the treatment of PAD. Although these methods are considered as a low invasive and low risk, some factors may limit stent patency in the future. The fracture of the implanted stent may be one of these.
Case report: A 68 old man, long-term smoker, with a history of chronic limb ischemia and many vascular surgeries because of PAD was admitted to the hospital with symptoms of the acute limb ischemia. Angiography showed a fracture of the stent implanted during the earlier hospitalization, with a fragment displacement to the left external iliac artery. The patient was successfully treated with catheter-directed thrombolysis.
Discussion: Stent fracture is usually asymptomatic, however, it may cause complications, such as restenosis, pseudoaneurysm, perforation of the vessel, and in-stent embolism. The cumulative incidence of the femoropopliteal stent fracture varies from 2 to 65% in several studies. Incidence increases with stent length and is significantly lower in the second generation of nitinol stents, that was designed to have enhanced flexibility and durability.


stent fracture; superficial femoral artery stenting; vascular surgery

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Hazarika S, Annex BH. Biomarkers and Genetics in Peripheral Artery Disease. Clin Chem. 2016;63(1):236-244.

Sampson UK, Fowkes FG, McDermott MM, Criqui MH, Aboyans V, Norman PE, et al. Global and regional burden of death and disability from peripheral artery disease: 21 world regions, 1990 to 2010. Glob Heart 2014; 9: 145–158.

McDermott MM, Greenland P, Liu K, Guralnik JM, Criqui MH, Dolan NC, Chan C, Celic L, Pearce WH, Schneider JR, Sharma L, Clark E, Gibson D, Martin GJ. Leg symptoms in peripheral arterial disease: associated clinical characteristics and functional impairment. JAMA. 2001 Oct 3;286(13):1599-606.

Hamburg NM, Creager MA. Pathophysiology of Intermittent Claudication in Peripheral Artery Disease. Circ J. 2017 Feb 24;81(3):281-289.

Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG; TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007 Jan;45 Suppl S:S5-67.

Adam DJ, Beard JD, Cleveland T, et al. Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL): multicentre, randomised controlled trial. Lancet 2005;366:1925-1934

Schillinger M, Sabeti S, Loewe C, Dick P, Amighi J, Mlekusch W, et al. Balloon angioplasty versus implantation of nitinol stents in the superficial femoral artery. N Engl J Med 2006;354(18):1879-88.

Nathan A, Kobayashi T, Giri J. Nitinol Self-Expanding Stents for theSuperficial Femoral Artery. Interv Cardiol Clin. 2017 Apr;6(2):227-233.

Scheinert D, Scheinert S, Sax J, Piorkowski C, Bräunlich S, Ulrich M, Biamino G, Schmidt A. Prevalence and clinical impact of stent fractures after femoropopliteal stenting. J Am Coll Cardiol. 2005 Jan 18;45(2):312-5.

Adlakha S, Sheikh M, Wu J, Burket MW, Pandya U, Colyer W, Eltahawy E, Cooper, CJ. Stent fracture in the coronary and peripheral arteries. J Interv Cardiol. 2010 Aug;23(4):411-9.

Park JY, Jeon YS, Cho SG, et al. Stent fractures after superficial femoral artery stenting. J Korean Surg Soc. 2012;83(3):183-6.

Iida O, Nanto S, Uematsu M, Morozumi T, Kotani J, Awata M, Onishi T, Ito N, Sera F, Minamiguchi H, Akahori H, Nagata S. Effect of exercise on frequency of stent fracture in the superficial femoral artery. Am J Cardiol. 2006 Jul 15;98(2):272-4.

Iida O, Nanto S, Uematsu M, Ikeoka K, Okamoto S, Nagata S. Influence of stent fracture on the long-term patency in the femoro-popliteal artery: experience of 4 years. JACC Cardiovasc Interv. 2009 Jul;2(7):665-71.

Sustained benefit at 2 years of primary femoropopliteal stenting compared with balloon angioplasty with optional stenting. Schillinger M, Sabeti S, Dick P, Amighi J, Mlekusch W, Schlager O, Loewe C, Cejna M, Lammer J, Minar E Circulation. 2007 May 29; 115(21):2745-9.

MINAR E, SCHILLINGER M. New stents for SFA. J Cardiovasc Surg (Torino). 2009, Oct;50(5):635-45.

Rundback JH, Herman KC, Patel A. Superficial femoral artery intervention: creating an algorithmic approach for the use of old and novel (endovascular) technologies. Curr Treat Options Cardiovasc Med. 2015;17:400.

Geraghty PJ, Mewissen MW, Jaff MR, Ansel GM; VIBRANT Investigators. Three-year results of the VIBRANT trial of VIABAHN endoprosthesis versus bare nitinol stent implantation for complex superficial femoral artery occlusive disease. J Vasc Surg. 2013 Aug;58(2):386-95.

Zhang L, Bao J, Zhao Z, Lu Q, Zhou J, Jing Z. Effectiveness of Viabahn in the Treatment of Superficial Femoral Artery Occlusive Disease: A Systematic Review and Meta-analysis. J Endovasc Ther. 2015 Aug;22(4):495-505.

Garcia LA, Rosenfield KR, Metzger CD, Zidar F, Pershad A, Popma JJ, Zaugg M, Jaff MR; SUPERB investigators. SUPERB final 3-year outcomes using interwoven nitinol biomimetic supera stent. Catheter Cardiovasc Interv. 2017 Jun 1;89(7):1259-1267.

Ohki T, Kichikawa K, Yokoi H, Uematsu M, Yamaoka T, Maeda K, Kanaoka Y. Outcomes of the Japanese multicenter Viabahn trial of endovascular stent grafting for superficial femoral artery lesions. J Vasc Surg. 2017 Jul;66(1):130-142.

Montero-Baker M, Ziomek GJ, Leon L, Gonzales A, Dieter RS, Gadd CL, Pacanowski JP Jr. Analysis of endovascular therapy for femoropopliteal disease with the Supera stent. J Vasc Surg. 2016 Oct;64(4):1002-8.

Lucatelli P, Cini M, Tommasino G, Benvenuti A, Guaccio G, Bascetta S, Neri E, Ricci C. Use of the Gore Tigris Vascular Stent in Advanced Femoropopliteal Peripheral Arterial Disease. J Vasc Interv Radiol. 2018 May;29(5):614-622.



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