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破裂的超交织镍钛诺支架所致腘动脉闭塞的血管内治疗

Endovascular Treatment of Popliteal Artery Occlusion Caused by a Ruptured Supera Interwoven Nitinol Stent.

作者信息

San Norberto Enrique M, Fidalgo-Domingos Liliana A, García-Saiz Irene, Taylor James, Vaquero Carlos

机构信息

Division of Vascular Surgery, Valladolid University Hospital, Valladolid, Spain.

Division of Vascular Surgery, Valladolid University Hospital, Valladolid, Spain.

出版信息

Ann Vasc Surg. 2019 Aug;59:308.e9-308.e13. doi: 10.1016/j.avsg.2019.02.050. Epub 2019 May 7.

Abstract

The Supera peripheral stent system has a woven wire design that may confer a potential advantage and has higher resistive radial strength of traditional stents, which gives it the ability to avoid kinking. Because a stent is a permanent implant in the target vessels and they would be subjected to a wide variety of torsion, compression, and stress, a rupture is not surprising. Only three cases of ruptured Supera stents have been published in literature. We present a case of P2 popliteal segment thrombosis secondary to Supera stent fracture. A 51-year-old male patient presented with lifestyle-limiting intermittent claudication after 6 months of popliteal recanalization and Supera stent implantation. The computed tomography angiography demonstrated a popliteal artery occlusion secondary to stent fracture. The lesion was satisfactorily treated by endovascular recanalization and with a new Supera stent deployment. The duplex examination after 3 and 6 months demonstrated stent's permeability, and the plain anteroposterior and lateral radiographs did not reveal new stent fractures. Our data suggested that Supera stents are not free of fractures during follow-up and their treatment depends on the type of fracture, with the possibility for endovascular treatment in type III fractures.

摘要

Supera外周支架系统采用编织金属丝设计,这可能带来潜在优势,且其径向抗阻强度高于传统支架,使其具备避免扭结的能力。由于支架是植入目标血管的永久性装置,会受到各种扭转、压缩和应力作用,因此发生破裂并不罕见。文献中仅发表过3例Supera支架破裂的病例。我们报告1例因Supera支架断裂继发P2腘动脉节段血栓形成的病例。1例51岁男性患者在腘动脉再通并植入Supera支架6个月后,出现影响生活方式的间歇性跛行。计算机断层扫描血管造影显示继发于支架断裂的腘动脉闭塞。通过血管内再通和植入新的Supera支架,病变得到了满意的治疗。3个月和6个月后的双功超声检查显示支架通畅,前后位及侧位X线平片未显示新的支架断裂。我们的数据表明,Supera支架在随访期间并非不会发生断裂,其治疗取决于骨折类型,Ⅲ型骨折有可能进行血管内治疗。

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