論文ID: CJ-18-1229
A 75-year-old man with long occlusion of the right superficial femoral artery (SFA) had undergone 2 Viabahn® (WL Gore & Associates, AZ, USA) 5.5–150-mm and 6.0–100-mm implantations 6 months previously (Figure A,B). As anti-thrombotic treatment, clopidogrel 75 mg/day and aspirin 100 mg/day were given for 1 month, and then clopidogrel was discontinued. Follow-up angiogram demonstrated no restenosis at the implant site (Figure C). Angioscopy (Zemporshe®, OVALIS, Osaka, Japan) showed several thin linear longitudinal thrombi and the naked graft on the inside of the Viabahn (Figure D,E). At the distal edge of the Viabahn, we observed a step between the stent graft and native SFA (Figure F). Neointimal proliferation or plaque growth were not observed.
(A) Baseline angiography showing long total occlusion in the right superficial femoral artery. (B) Lines, Viabahn implantation sites. (C) Six-month follow-up angiography showing good expansion. (D) Angioscopy showing the naked graft and (E) several longitudinal thrombi. (F) At the distal edge of the Viabahn, a step was observed.
Stent graft thrombosis is the disadvantage of covered stents. Edge restenosis is a known factor for Viabahn stent graft thrombosis.1 In the present case, the edge of the stent was smooth and did not show restenosis.
The Zemporshe high-resolution angioscope is equipped with a 0.48-megapixel equivalent resolution camera. In this case, Zemporshe could clearly visualize the histopathology inside the Viabahn implanted to the SFA.
The authors declare no conflicts of interest.
