Osteomyelitis of the spine and abscess formation in the left thigh after stent-graft implantation in the superficial femoral artery

Purpose: To present a rare case of abscess formation around a covered stent in the superficial femoral artery. Methods and Results: Two weeks after balloon dilation of a left superficial femoral artery (SFA) occlusion, during which a Hemobahn covered stent had been placed to treat dissection, a 77-year-old nondiabetic male developed i ntolerable pain and swelling of his left thigh. An abscess had formed aroun d the stent, which was patent; intravenous antibiotic therapy quelled the s ymptoms, and the patient discontinued his oral antibiotic regimen weeks aft er discharge. General septicemia ensued. Acute lower limb ischemia and excr uciating back pain prompted readmission. The SFA stent-graft occlusion requ ired femoropopliteal bypass; the abscess and spondylodiskitis that had deve loped in the T12 and L1 vertebrae responded to intravenous antibiotics. The patient is without signs of infection at 6 months. Conclusions: Local and systemic infections associated with intraluminal pro stheses are rare, and prophylactic antibiotic therapy is not commonly emplo yed. Balloon- or device-induced arterial injury may expose the arterial wal l to bacterial colonization, suggesting that patients receiving lengthy ste nts or experiencing arterial injury during angioplasty should receive antib iotics as a precautionary measure.