Perivascular inflammatory reaction to a Hemobahn stent-graft: diagnosis with 3D MR angiography.
OBJECTIVE
To present a rare perivascular inflammatory reaction to a commercially produced polytetrafluoroethylene-covered stent and demonstrate the utility of 3-dimensional (3D) magnetic resonance angiography (MRA) in the diagnosis of this phenomenon.


METHODS
Three weeks after percutaneous deployment of a Hemobahn stent-graft to treat a high-grade stenosis and aneurysm of the proximal left superficial femoral artery (SFA), a 70-year-old diabetic man developed fever, pain, and local swelling of the left thigh. Venous thrombosis was excluded by ultrasound imaging; a normal flow profile was seen in the left common and superficial femoral arteries. Blood analysis found elevated inflammatory markers. MRA revealed extensive soft-tissue edema and perivascular contrast enhancement around the left SFA, but the stent-graft was patent. The clinical symptoms resolved within 7 days after initiation of anti-inflammatory therapy. Follow-up MRA scans demonstrated significantly reduced inflammatory reaction over the next few months.


CONCLUSIONS
Symptomatic perivascular inflammatory soft-tissue response to a stent-graft can be diagnosed with MR imaging studies.
Juergens
Kai Uwe
KU
Department of Clinical Radiology, University of Münster, Germany. kujuerg@uni-muenster.de
Tombach
Bernd
B
Reimer
Peter
P
Vestring
Thomas
T
Heindel
Walter
W
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000628:therapy; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D020099:Coated Materials, Biocompatible / Q000009:adverse effects; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D011138:Polytetrafluoroethylene / Q000009:adverse effects; D011859:Radiography; D015607:Stents / Q000009:adverse effects*; D014657:Vasculitis / Q000175:diagnosis* / Q000209:etiology*
D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene