0:00

All right. Our next scan in the post-intervention

0:04

section is basically assessing stent patency.

0:08

We're going to do a focused review of the area of interest.

0:11

Obviously, there's aortic iliac atherosclerosis, and we're kind of

0:15

going down, looking at both the common

0:19

iliac arteries bifurcating to the external and internal iliac arteries.

0:24

That's what the closure device looks like.

0:27

This person has undergone a prior intervention, and that metallic

0:30

density with artifacts is just the closure device that they've used to

0:35

seal that access site. There is occlusion

0:38

of this

0:40

right superficial femoral artery, and right after

0:44

that occlusion is where we see the stent. So that's important to mention.

0:47

It's important to mention in a patient who has undergone surgery

0:51

if there is actually stenosis proximal to it, because

0:55

then the inflow to that

0:58

extremity has not really been taken care of, or it's a new thing that

1:02

needs to be addressed. So besides the fact that there is severe

1:06

stenosis of the superficial femoral artery proximal to the stent,

1:10

within the stent itself, if you look here, there's actually a

1:13

hypodensity within that suggests in-stent restenosis, and it's

1:17

causing varying degrees of

1:20

stenosis throughout its course. So right here, it's only about a mild

1:24

stenosis, but as you kind of come down more, there's severe

1:28

in-stent restenosis. I can lay out that

1:32

vessel nicely in a coronal format, and you can kind of

1:35

see the entire length of this stent

1:39

displayed in both a sagittal plane as well

1:43

as a coronal plane.

1:45

And you can see the extent of the in-stent restenosis

1:49

throughout the stented segment. So multifocal severe

1:53

in-stent restenosis in this superficial femoral artery.

1:57

And then in addition, there's also stenosis of that

2:01

native unstented segment, just proximal to that stent

2:05

as well as distal to the stent.

2:09

So all of this has implication in the management that they might

2:13

use to address the in-stent restenosis, as

2:17

well as the residual stenosis in the native vessels.