2011 Volume 20 Issue 4 Pages 737-740
Infection of bare metal stents in the vasculature is rare, but is associated with significant morbidity and mortality. We report a case of infected aneurysm due to bare metal stent infection. A 77-year-old man who had previously undergone the placement of bilateral lower extremity bare metal stents in the left common iliac artery and left superficial femoral artery (SFA) was readmitted with fever, anorexia, generalized malaise and multiple erythematous and macular lesions on his left leg. Blood cultures yielded Staphylococcus aureus and a computed tomographic scan showed aneurysmal dilation of the left SFA with contrast material filling the lumen outside the wall of the stent, which is consistent with pseudoaneurysm formation and elevated intensity of the tissues surrounding the SFA stent. We undertook immediate removal of the infected aneurysm. The left distal SFA was found to have a pseudoaneurysm associated with purulent fluid and a thrombus surrounding the bare metal stent. The wound was left open and was prepared for negative pressure wound therapy. Blood culture findings from the surgery were positive for Staphylococcus aureus. Eight days after first operation, the patient underwent revascularization from the proximal SFA to the below-knee popliteal artery with an in situ great saphenous vein graft. The patient was then discharged on a 6-week course of antibiotics. Infections of bare metal stent are potentially life-threatening complications and must be addressed urgently, including possible surgical intervention. Given the high morbidity and mortality of this fatal complication, as well as the minimal harm and cost involved in prophylaxis, prophylactic antibiotics should be administered in the standard fashion.