A case of occluded femoropopliteal saphenous vein bypass with threatening limb ischemia treated with endovascular stent graft relining

A 61-year-old man presented with chronic limb threatening ischemia due to reocclusion of a femoropopliteal (FP) bypass using a saphenous vein graft (SVG). After performing endovascular intervention using plain angioplasty and drug-coated balloon and drug-eluting stent implantation of the proximal anastomosis of FP bypass, refractory early reocclusion occurred during the perioperative period. Thus, we decided to alternatively place a stent-graft in the occluded FP bypass. After the SVG had been dilated using a high-pressure balloon, a stent-graft was successfully placed. This alternative therapy using a stent-graft prevented SVG FP bypass reocclusion, and the patient's ulcers had completely healed within 1 month.