A 37-year-old female underwent an emergent implant of a covered self-expandable stent graft (8mm x 10cm ^{Viabahn, W. L. Gore}) (Fig 1) due to acute bleeding from a femoral access following closure of a patent foramen ovale. Over the following months, intermittent claudication developed, progressively more incapacitant. Work-up revealed near-occlusion of the stent graft due to edge stenosis. Elective explant of the stent graft was performed, revealing extensive proximal and distal edge miointimal hyperplasia (marked with *). Endarterectomy was performed and the arterial defect was corrected with a bovine pericardium patch.

Figure 1 (8mm x 10cm Viabahn, W. L. Gore)