“Pseudo aortoiliac bifurcation” leading to significant plaqu
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"Plaque shifting is a serious complication of endovascular treatment (EVT) for aortoiliac bifurcation lesions. It is challenging to predict the occurrence of unfavorable plaque shifting correctly.

Case presentation

This article presents the case of an 88-year-old woman who experienced constant pain at rest in her left leg. The ankle-brachial pressure index of her left leg was 0.57. Computed tomography (CT) angiography revealed severe stenosis of the left common iliac artery (CIA) and total occlusion of the left external iliac artery (EIA). We diagnosed the patient with acute exacerbation of a chronic limb ischemia and administered endovascular treatment (EVT) to treat the left CIA and EIA. The results of initial angiography agreed with those of CT angiography. After placing a self-expandable stent for the left CIA lesion, significant unfavorable plaque shifting occurred. From a comparison between pre- and post-stenting angiography, authors realized that the plaque protrusion into the terminal aorta had formed a “pseudo aortoiliac bifurcation” that was situated more proximally compared to the true bifurcation.The patient ultimately developed fatal cholesterol embolization after EVT."....

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