Presenter: Kazuki Tobita

Affiliation: Shonan Kamakura General Hospital, Japan

Abstract

This article presents two cases of VIABAHN stent-graft deployment failure in severely calcified femoropopliteal lesions. Bail-out strategies including retrograde access and controlled stent extraction achieved successful revascularization, emphasizing calcification management.

Introduction

Severe calcification increases stent deployment failure risks. This report details technical salvage approaches for such scenarios.

Case Study

Case 1: A 70s male with Rutherford 5 ischemia. 

Antegrade VIABAHN deployment failed due to calcific resistance, requiring retrograde lesion preparation and stent re-deployment.

Case 2: An 80s female with iliac occlusion. 

Stent entrapment was resolved by non-compliant balloon crushing (30atm) and cautious system retrieval.

Both cases achieved limb salvage with 1-year patency.

Conclusions

1.Aggressive lesion preparation (e.g., high-pressure balloon) is critical for stent delivery.

2.Retrograde access and balloon crushing mitigate deployment failure.

3.Gentle manipulation preserves stent integrity during retrieval.