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Abstract:

Article presents a case of successful re-stenting of the left subclavian artery with good medium-term outcome in 59 years patient with a return of symptoms of vertebrobasilar insufficiency due to proximal fracture of previously implanted stent. The leading cause of stents destruction in the aortic arch branches are excessive mechanical load due to constant compression and/or vessel displacement, its compression due closeness of beating heart and movements of the shoulder girdle, which is likely had happened in our case - fracture of proximal segment. After analyzing the movement of vessels during the cardiac cycle, we found that stents in proximal aortic arch branches had been influenced mainly by bending, tension/compression. As a consequence - metal fatigue, which led it to the progressive destruction. Most stent fractures are asymptomatic, but in case of return of previous clinic - reintervention should be done. In this case, endovascular treatment is considered to be the method of first choice.


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