MRSA-infected external iliac artery pseudoaneurysm treated with endovascular stenting

A 48-year-old woman with severe juvenile-onset rheumatoid arthritis presented with a bleeding cutaneous sinus distal to her right total hip replacement scar. Methicillin resistant Staphylococcus aureus (MRSA) was isolated on culture. She had previously undergone bilateral total hip and knee replacem...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2005-04, Vol.28 (3), p.364-366
Main Authors: Clarke, M G, Thomas, H G, Chester, J F
Format: Article
Language:English
Subjects:
Aneurysm, False - microbiology
Aneurysm, False - surgery
Aneurysm, Infected - surgery
ARTERIES
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
BONE JOINTS
Cutaneous Fistula - microbiology
Female
GRAFTS
Hip joint
Humans
Iliac Aneurysm - microbiology
Iliac Aneurysm - surgery
Methicillin Resistance
Middle Aged
OSTEOMYELITIS
POLYTETRAFLUOROETHYLENE
RADIOLOGY AND NUCLEAR MEDICINE
RHEUMATIC DISEASES
SINUSES
Staphylococcal Infections - surgery
STAPHYLOCOCCUS
Staphylococcus aureus
Staphylococcus infections
Stents
WOMEN
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Summary:A 48-year-old woman with severe juvenile-onset rheumatoid arthritis presented with a bleeding cutaneous sinus distal to her right total hip replacement scar. Methicillin resistant Staphylococcus aureus (MRSA) was isolated on culture. She had previously undergone bilateral total hip and knee replacements at aged 23 and six years later had the right knee prosthesis removed for infection, with subsequent osteomyelitis of the femoral shaft and right total hip prosthesis disruption. Peripheral arteriography was performed in view of persistent bleeding from the sinus, which revealed a 6 cm false aneurysm filling from and compressing the right external iliac artery (EIA). A PTFE-covered, balloon expandable JOSTENT was deployed in the right EIA, successfully excluding the false aneurysm and preventing further bleeding from the sinus. No graft infection was reported at 12 months. This case illustrates the potential use of endovascular stent-grafting in the treatment of an infected pseudoaneurysm.
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-004-0254-7