Acute Compartment Syndrome Related to Stent-Graft Exclusion of a Popliteal Arterial Aneurysm

Abstract

The purpose of this morbidity and mortality case report is to discuss a characteristic of the Viabahn (W.L. Gore, Newark, DE) stent-graft deployment as well as a complication related to wire trauma during endovascular exclusion of a popliteal artery aneurysm. We encountered a phenomenon not described in the literature during deployment of a Viabahn stent graft. This necessitated further wire purchase, which resulted in perforation of a branch vessel within the calf. The rapid recognition of the clinical findings and prompt diagnosis of compartment syndrome was essential to early intervention, which prevented further complication and permanent sequelae.

Bowstring Phenomenon in Renal Artery Aneurysm Exclusion Using a Viabahn Stent Graft

“…To avoid this phenomenon, it is necessary to straighten tortuous vessels. Michael et al 8 reported 0.035-inch stiffer wire systems may be favorable. However, a 0.035-inch guidewire is not compatible with a <9 mm-diameter Viabahn stent graft when using 120-cm-delivery catheter length via 7-Fr guiding sheath.…”

Squat and Jump: A Rare Case of Stent-Graft Migration During Deployment

“…However, the present case illustrates more severe bowstring phenomenon. 4 This is a VIABAHN-specific phenomenon which results from its unique structure and deployment mechanism. The SG was covered by a polytetrafluoroethylene (PTFE) jacket, and deployment was accomplished by pulling on a PTFE suture that opens the constraining tetrafluoroethylene jacket from around the device.…”