Osteomyelitis of the spine and abscess formation in the left thigh after stent-graft implantation in the superficial femoral artery.
OBJECTIVE
To present a rare case of abscess formation around a covered stent in the superficial femoral artery.


RESULTS
Two weeks after balloon dilation of a left superficial femoral artery (SFA) occlusion, during which a Hemobahn covered stent had been placed to treat dissection, a 77-year-old nondiabetic male developed intolerable pain and swelling of his left thigh. An abscess had formed around the stent, which was patent; intravenous antibiotic therapy quelled the symptoms, and the patient discontinued his oral antibiotic regimen weeks after discharge. General septicemia ensued. Acute lower limb ischemia and excruciating back pain prompted readmission. The SFA stent-graft occlusion required femoropopliteal bypass; the abscess and spondylodiskitis that had developed in the T12 and L1 vertebrae responded to intravenous antibiotics. The patient is without signs of infection at 6 months.


CONCLUSIONS
Local and systemic infections associated with intraluminal prostheses are rare, and prophylactic antibiotic therapy is not commonly employed. Balloon- or device-induced arterial injury may expose the arterial wall to bacterial colonization, suggesting that patients receiving lengthy stents or experiencing arterial injury during angioplasty should receive antibiotics as a precautionary measure.
Brodmann
M
M
Division of Angiology, Karl-Franzens University Graz, Austria.
Stark
G
G
Pabst
E
E
Lueger
A
A
Tiesenhausen
K
K
Szolar
D
D
Pilger
E
E
D000038:Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D000368:Aged; D000900:Anti-Bacterial Agents; D001157:Arterial Occlusive Diseases / Q000601:surgery; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D009135:Muscular Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011475:Prosthesis Failure; D013122:Spinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color
D000900:Anti-Bacterial Agents