Fracture of a drug-eluting stent in the tibioperoneal trunk following bifurcation stenting

Purpose: To report a complication of stent placement at a bifurcation in the infrapopliteal arteries. Case Report: A 60-year-old man presented with a complex subtotal stenosis in the anterior tibial artery and the tibioperoneal trunk. Two drug-eluting stents were implanted by means of the crush technique, successfully recanalizing the trifurcation. One week later, the patient was readmitted with a thrombotic occlusion of the popliteal artery. Fluoroscopy showed a fracture of the larger stent in the tibioperoneal trunk. After successful local thrombolysis, a stent fragment was located in the popliteal artery and removed with an Amplatz snare. Long-term follow-up was uneventful. Conclusion: Fracture may be a more common complication of bifurcation stenting when undertaken in a territory at high risk for this complication.