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[Propionibacterium granulosum bare-metal stent infection after drug-eluting balloon].

Authors: J, Hernigou; A, Gordienco; B, Dakhil; P, Longuet; J-C, Couffinhal; P, Bagan;

[Propionibacterium granulosum bare-metal stent infection after drug-eluting balloon].

Abstract

Bare-metal stents are used to treat arterial stenotic lesions. Morbidity and mortality are less important compared with other techniques. Drug-eluting balloons are often used to treat stent stenosis. We reported the case of a bare-metal stent infection after drug-eluting balloon and a review on the subject.Two weeks after percutaneous transluminal angioplasty with paclitaxel-eluting balloon and a bare-metal stent, our patient presented an infection of the stent. Diagnosis was based on the clinical presentation, positron emission tomography findings and isolation of Propionibacterium granulosum in repeated blood cultures. Adapted antibiotic therapy was given for three months with removal of the surgical bare-stent. Antibiotic therapy was interrupted after a second positron emission tomography. A literature search (PubMed and Cochrane) was performed on the subject.We found 49 cases of peripheral bare-metal stent infection including our patient. This is a rare but serious complication with a high morbidity (25% amputation rate) and mortality (30%). It seems to be underestimated. Treatment is based on surgical ablation of the bare-metal stent and intravenous antibiotics. The role of the paclitaxel-eluting balloon is not clearly established but some authors believe that it can produce a local immunosuppression.We report the first case of bare-metal stent infection after paclitaxel-eluting balloon. This complication is rare and difficult to diagnose. Manifestations are often limited to skin signs. Functional and vital prognosis is poor.

Related Organizations
Keywords

Aged, 80 and over, Piperacillin, Paclitaxel, Amoxicillin, Penicillanic Acid, Bacteremia, Coronary Disease, Arteriosclerosis Obliterans, Anti-Bacterial Agents, Coronary Restenosis, Femoral Artery, Alloys, Equipment Contamination, Humans, Female, Angioplasty, Balloon, Coronary, Gentamicins, Device Removal, Gram-Positive Bacterial Infections, Immunosuppressive Agents

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Powered by OpenAIRE graph
Found an issue? Give us feedback
selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
5
Average
Top 10%
Top 10%
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