An unusual late complication after SFA stenting: the artery rupture

Peripheral artery rupture as a late complication of an endovascular stenting, due to the protrusion of a stent, has never been described in the literature in thigh arteries. Here we describe two anecdotic cases of artery rupture after superficial femoral artery (SFA) stenting. In both cases the endovascular procedure was performed as a reintervention at 2 and 27 months after a failed surgical or hybrid procedure for limb revascularization. The stent had been delivered in the first part of the SFA and the rupture occurred at the junction between the common femoral artery and SFA, which is one of the most flexible parts of the femoral artery. The cause of rupture was probably caused by an ulcer of the stent against the artery wall concomitant with a status of local or systemic infection. A huge pseudoaneurysm developed in both cases. The massive bleeding was stopped by an emergency surgical bypass, with the removal of the stented artery. These two cases show the possibility of SFA rupture after stenting. Previous surgical treatment, the site of stenting (first part of the SFA) and an active infection could predispose patients to this life-threatening complication.