Uncovering the Unexpected-True Lumen Compression by Subintimal Stent Causing Recurrent Acute Limb Ischemia for 15 Years: A Case Report.

The mechanism of stent failure in acute limb ischemia includes a broad spectrum of thrombotic and mechanical factors. We present a patient with recurring Rutherford Class 2A acute limb ischemia, who underwent peripheral angiography demonstrating severe compression of the left superficial femoral artery true lumen by an old subintimal stent. This compression-the cause of recurring limb ischemia events over 15 years-was treated with side-by-side stenting of the true lumen. Diagnosed by fluoroscopy and intravascular ultrasound, true lumen compression by a subintimal stent is a rare mechanical complication of peripheral angioplasty and requires true lumen stenting for definitive management.