Late chronic total occlusion of infrarenal aortic stent graft and iliac branch device presenting as chronic limb-threatening ischemia

An 83-year-old man was admitted to our department with a diagnosis of right-sided chronic limb-threatening ischemia (CLTI), staged as Rutherford classification 5 with a non-healing ulcer and rest pain of the first toe, and gastric cancer. His history included endovascular aortic repair with a left-sided iliac branch device (IBD) (GORE® EXCLUDER® AAA C3 and Iliac Branch Endoprostheses [W. L. Gore & Associates, Flagstaff, AZ, USA]), and right internal iliac artery coil-embolization for 36-mm abdominal aortic, 35-mm right common, 35-mm right internal, and 45-mm left common iliac artery aneurysms (IAAs) 76 months previously.