2022 Volume 31 Issue 1 Pages 1-5
67-year-old male underwent right and left femoral popliteal below knee (F-PBK) bypass surgery (right with prosthetic bypass and left with autologous vein bypass). Two years after the right F-PBK bypass operation he suffered from sudden pain of right lower thigh with his foot skin cold and he was transferred to our hospital, diagnosed with acute limb ischemia due to prosthetic bypass occlusion. We didn’t know the exact mechanism of the occlusion and performed emergent thrombectomy through prosthetic bypass and anterior tibial artery. Following contrast CT scan revealed remaining stenosis and thrombus nearby distal anastomosis at right knee. Three dimentions (3D) CT analysis revealed that right knee flection had caused deformity and stenosis of prosthetic bypass, which seemed to be the origin of the thrombosis. To prevent re-occlusion, we placed two bare metallic stents overlappingly into it. One year has passed without re-occlusion of the bypass. Certainly this case is not a common method, but it could be one mean for stenosis of F-PBK prosthetic bypass which seems to have few choices to treat.
