title: Successful antibiotic treatment of severe staphylococcal infection of a long stent graft in the superficial femoral artery with graft preservation in the long term.
abstract: BACKGROUND
  Bacterial infection of endovascular stent grafts is a serious condition, regularly leading to graft replacement by open bypass surgery.
  
  
  METHODS
  We describe the case of a staphylococcal infection of a 150-mm covered stent graft (Gore Viabahn), placed in the superficial femoral artery. Stent graft infection was successfully treated by oral administration of penicillinase-resistant flucloxacillin and the lipopeptide daptomycin with complete graft preservation, not requiring surgical treatment. During 1-year follow-up, the graft infection did not reappear. However, the patient developed restenosis at the proximal margin of the stent with recurrence of mild claudication, so far treated conservatively.
  
  
  CONCLUSIONS
  With the increased use of covered stent grafts in the peripheral vasculature, the frequency of graft infection will increase. We demonstrate that with newly developed antibiotics, it is possible to treat this severe complication conservatively, with complete graft preservation and without the need for bypass surgery in selected cases.
authors.affiliation: Department for Clinical Radiology, Clinical Center of the Ludwig-Maximilians-University of Munich, Pettenkoferstr. 8a, 80336, Munich, Germany. Marcus.Treitl@med.uni-muenchen.de
authors.forename: Marcus
authors.initials: M
authors.lastname: Treitl
authors.forename: Antje
authors.initials: A
authors.lastname: Rademacher
authors.forename: Johanna
authors.initials: J
authors.lastname: Becker-Lienau
authors.forename: Maximilian F
authors.initials: MF
authors.lastname: Reiser
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Michael
authors.initials: M
authors.lastname: Czihal
mesh_terms: D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D017576:Daptomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005263:Femoral Artery; D005436:Floxacillin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015641:Radiography, Interventional; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015607:Stents; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents; D005436:Floxacillin; D017576:Daptomycin