We report a case of an 81 year old man who was treated for recurrent acute limb ischemia of the right leg. The patient had a prosthetic femoropopliteal bypass inserted 25 years ago.
This reconstruction was replaced with a new prosthetic bypass 10 years later. The patient was readmitted for acute limb ischemia in May 2006.
Because of several comorbidities at that time, surgery was not possible and endovascular treatment was undertaken with rheolytic thrombectomy and angioplasty with bailout stenting of the distal anastomosis of the femoropopliteal bypass. Two years after this intervention, the patient presented with acute limb ischemia due to reocclusion of the femoropopliteal bypass.
He was then treated with catheter directed local thrombolysis and a stent fracture was found in the distal anastomosis of the bypass. This was the primary cause of the reocclusion of the bypass.