Peripheral Artery Stent Dehiscence: Percutaneous Management.

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Cardiology

Background:

• Aortoiliac occlusive disease management often involves endovascular stenting.
• Post-stenting complications, such as retroperitoneal hematoma, require prompt diagnosis and intervention.

Observation:

• An elderly male presented with abdominal swelling and limb dysfunction following iliac artery stenting.
• Clinical and imaging revealed a large retroperitoneal hematoma with active extravasation from the left external iliac artery.
• The patient was deemed high surgical risk due to left ventricular dysfunction.

Findings:

• Urgent catheterization and aortography confirmed active bleeding into the retroperitoneal space.
• Initial balloon occlusion failed to control the hemorrhage.
• Successful percutaneous endovascular repair was achieved using overlapping covered stents in the left external iliac artery.

Implications:

• Covered stent deployment is an effective minimally invasive treatment for post-stenting arterial hemorrhage.
• This approach offers a viable alternative for high-risk surgical patients.
• Successful endovascular management led to rapid clinical improvement and hematoma resolution.