Delayed stent erosion and rupture of the external iliac artery following intraoperative stent placement at the time of common femoral endarterectomy

A case of delayed stent erosion and rupture of the external iliac artery following intraoperative stent placement is presented. A 60-year-old male with gangrenous changes of both feet underwent arteriography which demonstrated diffuse bilateral distal external iliac artery stenoses, preocclusive right common femoral artery stenosis, left common femoral artery occlusion, bilateral profunda femoral origin stenoses, and bilateral long segment occlusions of the superficial femoral arteries. The patient underwent bilateral common femoral and profunda origin endarterectomy and bilateral femoral-popliteal bypass with intraoperative bilateral external iliac artery stent placement. The patient presented 34 days later with a life-threatening rupture of the right external iliac artery secondary to stent erosion. The possible etiology and implications are discussed.