Three months later there was ATA restenosis and fibular artery reocclusion. Plain balloon angioplasty of the ATA (Fig. 3) was successful (diameter 3.25mm). Eight months later the patient returned with phlegmon. The ATA was still patent, but because of ATA restenosis (the second restenosis at the same site) we decided to implant an NIR stent 25mm dilated by 3.5mm balloon (Fig. 4). Since this procedure the patient has been symptom-free for nine months and the defect has healed.
Stent implantation can help to maintain the flow to the periphery in those cases where PTA fails because of restenosis, elastic recoil or occlusive dissection. It is known that stented arteries tend to occlude in the long run (but most patients do not have follow-up angiography and we use it only in clinical failures).Another option is to perform a simple Duplex sonography to confirm patency of the intervene vessles.We have experienced that if a reopened artery (with or without a stent) stays open long enough for defect healing to occur, the symptomatic period has been successfully handled.
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