Akai T, Ninomiya S, Kaneko T. Superficial femoral artery pseudoaneurysm at implantation site of drug eluting stent discovered due to bacteremia: A case report. World J Clin Cases 2024; 12(17): 3194-3199 [PMID: 38898869 DOI: 10.12998/wjcc.v12.i17.3194]
Corresponding Author of This Article
Takafumi Akai, MD, PhD, Chief, Department of Vascular Surgery, Asahi General Hospital, I-1326, Chiba, Asahi 289-2511, Japan. taka_akai@hotmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Takafumi Akai, Shintarou Ninomiya, Takanori Kaneko, Department of Vascular Surgery, Asahi General Hospital, Chiba, Asahi 289-2511, Japan
Author contributions: Ninomiya S contributed to data collection and supervision; Kaneko T contributed to conceptualization and data collection; Akai T contributed to manuscript writing and editing; all authors have read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this case report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no competing financial interests or personal relationships that may have influenced the work reported in this study.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Takafumi Akai, MD, PhD, Chief, Department of Vascular Surgery, Asahi General Hospital, I-1326, Chiba, Asahi 289-2511, Japan. taka_akai@hotmail.com
Received: February 9, 2024 Revised: April 20, 2024 Accepted: April 28, 2024 Published online: June 16, 2024 Processing time: 120 Days and 0 Hours
Abstract
BACKGROUND
Drug-eluting stents (DES) are used to treat lower extremity arterial disease. During DES treatment, aneurysmal degeneration occasionally occurs, especially with fluoropolymer-based DES. However, the incidence of pseudoaneurysms after DES placement is rarely reported in the lower extremity region, although there have been several reports on pseudoaneurysm formation after DES pla-cement in the coronary artery region.
CASE SUMMARY
We report the case of a 64-year-old man who presented with fever and pain in his left hand after dialysis. Bacteremia was diagnosed by blood culture, and after admission, he developed pain on the medial side of the right thigh. A pseudoaneurysm was observed in the right superficial femoral artery (SFA) at the proximal end of a previously placed DES. The bacteremia was thought to have been caused by a pseudoaneurysm of the left superficial brachial artery, and the pseudoaneurysm of the left superficial brachial artery was removed after antibiotic treatment. The pseudoaneurysm of the right SFA rapidly expanded after admission, but the expansion rate was reduced after infection control. Seven months after the first admission, the pseudoaneurysm of the left SFA was re-moved and in situ revascularization performed using a rifampicin-soaked Dacron graft.
CONCLUSION
Although pseudoaneurysm after DES placement in the lower extremity region is rare, it must be considered in patients with bacteremia.
Core Tip: We report a relatively rare case of pseudoaneurysm formation after the placement of a drug-eluting stent in the superficial femoral artery. This pseudoaneurysm was discovered after the development of bacteremia and removed because of suspicion of an infected aneurysm. This report describes an uncommon presentation of pseudoaneurysm, which suggests that pseudoaneurysm should be considered as a differential diagnosis along with degenerative aneurysm in patients with bacteremia after placement of a drug-eluting stent.
