Although several clinical reports demonstrated a durable patency rate after a novel
fluoropolymer-coated
paclitaxel-eluting
stent (Eluvia; Boston Scientific, Marlborough, MA, USA) placement, aneurysmal degeneration after
drug-eluting stent (Eluvia) placement has raised clinical concerns. Here, we report a case with progressive
aneurysm formation on serial angiography and intravascular ultrasound over 50 months after
drug-eluting stent (Eluvia) placement for a superficial femoral artery
atheromatous plaque.
CASE PRESENTATION: A 79-year-old woman with right leg
intermittent claudication at 100 m distance was referred to our hospital. Pre-procedural angiography showed long-segment severe
stenosis from the middle-to-distal part of the right superficial femoral artery, and a 7 mm wide
drug-eluting stent (Eluvia) was placed. However, the patient had a recurrence of
intermittent claudication in the right lower extremity 25 months thereafter. Angiography revealed de novo
stenosis in the distal part of the popliteal artery and proximal superficial femoral artery in-
stent restenosis. Subsequently, the patient underwent endovascular
therapy for these lesions. In addition, intravascular ultrasound at the time of endovascular
therapy revealed femoral artery enlargement with a maximum vessel diameter of 10.0 mm at the distal edge of the
stent.
Intermittent claudication on the right side recurred again 50 months after
drug-eluting stent (Eluvia). Angiography demonstrated de novo severe
stenosis from the distal part of the superficial femoral artery to the middle part of the popliteal artery. Peri-
stent contrast staining was found at the distal part of the
drug-eluting stent (Eluvia) site. Intravascular ultrasound showed a further enlargement of maximum vessel diameter to 12.0 mm at the distal edge of the
stent.
CONCLUSIONS: We report a case with progressive
aneurysm degeneration on serial angiography and intravascular ultrasound over 50 months after
drug-eluting stent (Eluvia) placement for a superficial femoral artery
stenosis.