Infections of Intravascular Bare Metal Stents: A Case Report and Review of Literature

Abstract

Intravascular stent infection is associated with a high risk of morbidity and mortality. Surgery is the preferred treatment option, but not always possible, especially in patients with a coronary stent. In selected cases, bare metal stent infections may be prevented by the use of prophylactic antibiotics at stent placement.

Bare Metal Stent Infection: Case Report and Literature Review

“…[4]. Common organisms cultured in endovascular device infections were noted to be Staphylococcus aureus at 54.4% [3,4]. Furthermore, Fiorini et al, found that Staphylococcus aureus accounted for 70% of early infections and 30% of later diagnosed infections [5].…”

“…Furthermore, Fiorini et al, found that Staphylococcus aureus accounted for 70% of early infections and 30% of later diagnosed infections [5]. Bosman et al discovered that 76.6% of infected endovascular devices were caused by Staphylococcus aureus [4]. Lichtenfels et al suggest the main factors associated with development of infection in endovascular devices are found with immunodepression, specific site of endovascular procedure, previous pseudo and mycotic aneurysms, presence of neoplasm, and use of corticosteroids [6,7].…”

“…Detection of infections remains difficult because of the primary presentation of nonspecific symptoms. Common presenting symptoms noted by Fiorini et al were light fever, malaise, chills, leukocytosis, pain in the area of stent placement, high inflammatory markers, weight loss, nausea, and anemia [4,5]. Fiorini et al stated that most cases of endograft infection usually occur after more than four months post procedure [5].…”

“…With non-specific symptoms, imaging procedures, such as the computed tomography scans done in our case, usually makes many diagnoses of complication of endovascular device placement and/or infection. [4]. Common organisms cultured in endovascular device infections were noted to be Staphylococcus aureus at 54.4% [3,4].…”

Late Complication after Superficial Femoral Artery (SFA) Aneurysm: Stent-graft Expulsion Outside the Skin

“…Diabetes and smoking independently increase the infection risk; however, other risk factors previously reported for endovascular procedures, such as absence of sterility, lack of antibiotic prophylaxis, introducer sheath permanence more than 24 h, multiple stents implantation, or multiple procedures in the same region [3], were not present in our case. Infected stent and/or stent-graft usually appear as device thrombosis, septic embolization, pseudoaneurysm, and hemorrhage [10]. Schneider et al [3] reported a single case of SFA autolysis after Viabahn stent-graft implantation for SFA atherosclerotic disease.…”