83 year old female with history of hypertension, type 2 diabetes mellitus, dyslipidemia, ex-smoker (25 pack year) and known history of peripheral artery disease. She underwent angioplasty of the right superficial femoral artery in May, 2014 with Everflex 6.0 x 200 mm and 6.0 x 80 mm stent with good angiographic and clinical results.
In May 2017 she was presented again with worsening lower extremity claudication, right > left. Ankle brachial index was 0.62 in right leg and 0.88 in left leg. Angiogram done on July 31, 2017 showed instent occlusion of the right superficial femoral artery stent, extending from proximal edge to the distal segment. SFA reconstituted in the distal stented segment. Antegrade attempt at crossing the total occlusion did not succeed because of unfavorable cap anatomy and flush occlusion of SFA.
