# Early Supera stent fracture after treatment of popliteal artery occlusion caused by artificial knee joint: a case report

## TL;DR

A case report describes an 86-year-old woman who experienced early Supera stent fracture in the popliteal artery, possibly due to proximity to an artificial knee joint and vascular abnormalities.

## Contribution

This case highlights a rare early fracture of the Supera stent in the popliteal artery, potentially linked to artificial joint proximity and vascular anatomy.

## Key findings

- Supera stent fracture occurred 6 months post-implantation in the popliteal artery.
- Fracture site was near an artificial knee joint and a medially deviated artery, suggesting entrapment syndrome.
- Endovascular treatment with balloon angioplasty was performed due to risks of additional stenting.

## Abstract

The Supera stent, a self-expanding interwoven nitinol stent, has greater radial force than conventional stents, resulting in high patency and reduced stent fracture. There have been few reports of early stent fracture, and it is considered an effective device in the popliteal artery.

We present a case of popliteal artery occlusion due to Supera stent fracture. An 86-year-old woman presented to our department with intermittent claudication after 6 months of Supera stent implantation. Ultrasonography demonstrated popliteal artery occlusion secondary to Supera stent fracture. Fluoroscopy revealed that the stent had fractured at the site closest to the artificial knee joint and might have been in contact with a vessel. In addition, the popliteal artery was slightly deviated medially in the P2 segment, suggesting popliteal artery entrapment syndrome. Because additional stenting was considered a risk for further stent failure, it was decided to complete endovascular treatment with balloon angioplasty alone and then consider bypass treatment.

Although the Supera stent is a useful stent, it would be prudent to avoid popliteal artery stenting in the presence of abnormal vascular running or artificial joint is observed.