Delayed Stent Infection after Deployment of a Carotid Dual Layer Stent in Dialysis Cases.

Journal of neuroendovascular therapy Pub Date : 2024-01-01 Epub Date: 2024-02-15 DOI:10.5797/jnet.cr.2023-0081
Tetsuya Ioku, Keisuke Imai, Takehiro Yamada, Masanori Cho, Toshi Sai, Takuma Kato
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Abstract

Objective: Infection after carotid artery stenting (CAS) is rare. We report two dialysis cases of delayed stent infection associated with a carotid dual-layer stent (DLS), which occurred several months after deployment of the stent.

Case presentations: Case 1: A 74-year-old man receiving dialysis underwent CAS with DLS. Three months after CAS, the patient developed a high fever, neck pain, and neck swelling. Neck CT and carotid ultrasonography (CUS) indicated an abscess around the inserted DLS. The patient was treated with antibiotic agents and fully recovered. Case 2: A 73-year-old man receiving dialysis underwent CAS with DLS. Two months after CAS, this patient also developed a high fever, neck pain, and neck swelling. Contrast-enhanced neck CT indicated inflammatory effusion with an abscess and a giant infectious pseudoaneurysm. Endovascular stent graft reconstruction was employed urgently under antibiotic therapy to prevent its rupture. However, intracranial hemorrhage occurred postoperatively and left hemiparesis remained.

Conclusion: Delayed carotid stent infection is a rare but severe complication. The use of a DLS might be avoided during CAS for dialysis cases.

透析病例使用颈动脉双层支架后的延迟支架感染。
目的:颈动脉支架置入术(CAS)后感染非常罕见。我们报告了两例与颈动脉双层支架(DLS)相关的延迟支架感染透析病例,感染发生在支架植入数月后:病例 1:一名接受透析的 74 岁男性接受了带有 DLS 的 CAS。CAS 术后三个月,患者出现高烧、颈部疼痛和颈部肿胀。颈部 CT 和颈动脉超声检查(CUS)显示,插入的 DLS 周围有脓肿。患者接受抗生素治疗后完全康复。病例 2:一名正在接受透析的 73 岁男子接受了带 DLS 的 CAS 手术。CAS 两个月后,该患者出现高烧、颈部疼痛和颈部肿胀。对比增强颈部 CT 显示炎性渗出伴有脓肿和巨大感染性假动脉瘤。为防止其破裂,在抗生素治疗下紧急采用了血管内支架移植重建术。然而,术后发生了颅内出血,左侧偏瘫仍然存在:结论:延迟性颈动脉支架感染是一种罕见但严重的并发症。结论:延迟性颈动脉支架感染是一种罕见但严重的并发症,透析病例在进行 CAS 时应避免使用 DLS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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