Early stent thrombosis after superficial femoral artery stenting successfully treated with transcatheter rheolytic thrombectomy in a patient with reduced aspirin responsiveness

Purpose: To describe a case of early superficial femoral artery (SFA) thrombosis after stenting in an aspirin low-responsive patient successfully treated with percutaneous mechanical thrombectomy. Clinical and interventional summary: Early SFA stent thrombosis occurred in a 65-year-old man treated with multiple stent implantation for chronic total occlusion of the left SFA. The potential cause for thrombosis was a suboptimal PTA [percutaneous transluminal angioplasty] result characterized by no-flow limiting residual linear dissection left untreated and which was associated with low responsiveness to aspirin. Rapid thrombus removal and flow restoration were obtained with the Angiojet Ultra Thrombectomy System (Medrad, Warrendale, PA, USA). Conclusions: Treatment of SFA stent thrombosis should be undertaken with the understanding of the underlying thrombotic causes and the knowledge of the most appropriate therapeutic options. A percutaneous mechanical strategy with the Angiojet Ultra Thrombectomy System may achieve rapid and complete recanalization even in the presence of huge thrombotic burden.<. Learning objective: New devices have been available for huge thrombotic burden management in acute clinical peripheral settings. A few clinical experiences have been described and the case we present shows the safety and efficacy of the rheolytic thrombectomy for femoral stent thrombosis management avoiding bleeding and distal embolization risks.