San Norberto Enrique M, Fidalgo-Domingos Liliana A, García-Saiz Irene, Taylor James, Vaquero Carlos
Division of Vascular Surgery, Valladolid University Hospital, Valladolid, Spain.
Division of Vascular Surgery, Valladolid University Hospital, Valladolid, Spain.
Ann Vasc Surg. 2019 Aug;59:308.e9-308.e13. doi: 10.1016/j.avsg.2019.02.050. Epub 2019 May 7.
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.
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。
