Potential risk of rupture of repeated angioplasty in patient with in-stent restenosis after subintimal angioplasty for heavily calcified SFA lesion.

Sub-intimal angioplasty is a relatively safe and effective strategy for the treatment of long and total occluded segment of superficial femoral artery. However, since wiring and stenting is usually guided by angiographic image, to confirm the exact layer of stent implantation is difficult. Computed tomography (CT) angiographic images could be informative to identify the stent position in arterial wall. We report our case to emphasize the importance of CT imaging in determining the appropriate strategy for the treatment of an in-stent restenosis lesion that was previously performed via subintimal approach. .