Primary stenting for chronic total occlusion of the infrarenal aorta

To present a rare case of chronic total occlusion of the infrarenal aorta treated with a self-expanding endoluminal stent implanted without preliminary dilation.

A 68-year-old woman presented with severe bilateral buttock and thigh claudication. Angiography revealed total occlusion of the infrarenal abdominal aorta and relatively normal iliac vessels. Via a right groin puncture and a 9-F sheath, a 14-mm x 5-cm self-expanding Wallstent was deployed in the abdominal aorta and expanded with an angioplasty balloon. Completion angiography showed successful recanalization of the aorta with satisfactory distal flow. Palpable distal pulses were restored, and the patient's symptoms were alleviated. She remained asymptomatic until her death from a major stroke 11 months after aortic stent implantation.

Primary stenting may be considered a viable alternative to conventional surgery in selected patients with total infrarenal aortic occlusion.