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Successful Treatment of an Above-Knee Femoropopliteal Bypass Anastomotic Stenosis with the aSpire Covered Stent

Kaiser Permanente Medical Center, Santa Clara, California; Stanford University Medical Center Stanford, California; bhill{at}stanford.edu

Rishad M. Faruqi, MD

Christine E. Newman, RN

Kaiser Permanente Medical Center, Santa Clara, California; Stanford, CA

Frank R. Arko, MD

Thomas J. Fogarty, MD

Christopher K. Zarins, MD

Stanford University Medical Center Stanford, California; Santa Clara, CA

Prosthetic femoropopliteal grafts are commonly used for treating lower extremity arterial occlusive disease. Late graft failure may result from the progression of atherosclerosis or stenosis caused by myointimal hyperplasia at the sites of anastomosis. This report describes the use of an aSpire stent (Vascular Architects Inc. San Jose, CA) in the successful treatment of an anastomotic stenosis in a 64-year-old woman. The stent consists of a helical nitinol framework that is completely covered with expanded polytetrafluoroethylene. It is selfexpanding and highly flexible with strong radial force, and offers the unique features of variable endoluminal coverage and the ability to maintain patency of important arterial side branches. In the case presented here, the stent successfully corrected the anastomotic stenosis and preserved both antegrade and retrograde blood flow into the above-knee popliteal artery as demonstrated by Duplex ultrasonography at 16 months and an ankle-brachial index of 1.0 and freedom from claudication almost 2 years after stent placement. The aSpire Covered Stent provides an alternative treatment option for correcting an anastomotic stenosis in a failing femoropopliteal graft.

Key Words: aSpire stent • covered stent • peripheral arterial stent • femoropopliteal graft occlusion • anastomotic stenosis • side branch patency

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