Subclavian arteritis and pseudoaneurysm formation secondary to stent infection

Adel M. Malek, Randall T. Higashida, Linda M. Reilly, Wade S. Smith, Sang Mo Kang, Daryl R. Gress, Philip M. Meyers, Constantine C. Phatouros, Van V. Halbach, Christopher F. Dowd

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Technically uncomplicated percutaneous angioplasty and stent placement of a left subclavian artery stenosis was performed in a 56-year-old man for treatment of subclavian steal syndrome and vertebrobasilar insufficiency. Six days later the patient was readmitted with Staphylococcus aureus bacteremia and stigmata of septic emboli isolated to the ipsilateral hand. Nine days later he had computed tomography (CT) evidence of a contrast-enhancing phlegmon surrounding the stent. Despite clinical improvement and resolution of bacteremia on intravenous antibiotic therapy, the phlegmon progressed, and at day 21 a pseudoaneurysm was angiographically confirmed. The patient underwent surgical removal of the stented arterial segment and successful autogenous arterial reconstruction. The possible contributory factors leading to stent infection were prolonged right femoral artery access and an infected left arm venous access. Although the role of prophylactic antibiotics remains to be defined, it may be important in cases where the vascular access sheath remains in place for a prolonged period of time.

Original languageEnglish (US)
Pages (from-to)57-60
Number of pages4
JournalCardiovascular and Interventional Radiology
Volume23
Issue number1
DOIs
StatePublished - Jan 2000

Keywords

  • Endovascular therapy
  • Percutaneous balloon angioplasty
  • Phlebitis
  • Subclavian steal syndrome
  • Vertebrobasilar insufficiency

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Malek, A. M., Higashida, R. T., Reilly, L. M., Smith, W. S., Kang, S. M., Gress, D. R., Meyers, P. M., Phatouros, C. C., Halbach, V. V., & Dowd, C. F. (2000). Subclavian arteritis and pseudoaneurysm formation secondary to stent infection. Cardiovascular and Interventional Radiology, 23(1), 57-60. https://doi.org/10.1007/s002709910009