Arterial infection and staphylococcus aureus bacteremia after transfemoral cannulation for percutaneous carotid angioplasty and stenting.
In this report, we present a patient who developed an infected femoral artery after repuncture cannulation for carotid angioplasty and intraluminal stenting. The case was complicated by persistent bacteremia and a delay in diagnosis before it was managed successfully with an autogenous replacement graft and appropriate antibiotics. Overt stent infection is exceedingly rare, but according to the literature describing transfemoral coronary artery intervention, the spectrum of clinical syndromes related to infection of the arterial puncture site includes local invasion, pseudoaneurysm formation, septic embolization to the distal limb, and bacteremia. The diagnosis requires a high degree of clinical suspicion and is often delayed. Although the incidence of infectious complications reported for percutaneous intra-arterial interventions historically has been low, the absolute number of these complications almost certainly will increase in the future because of the expanding array of interventional procedures that is becoming available.
Culver
Daniel A
DA
Internal Medicine Residency Program, The Cleveland Clinic Foundation, Ohio 44195, USA.
Chua
Jimmy
J
Rehm
Susan J
SJ
Whitlow
Patrick
P
Hertzer
Norman R
NR
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation*; D016470:Bacteremia / Q000209:etiology*; D017536:Carotid Artery, Common / Q000601:surgery*; D002404:Catheterization / Q000009:adverse effects; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D013203:Staphylococcal Infections / Q000209:etiology*; D013211:Staphylococcus aureus; D015607:Stents / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000209:etiology