Coronary stent infections: A case series

Schoenkerman, Aaron B.; Lundstrom, Robert J.

doi:10.1002/ccd.21804

Cited by 25 publications

(13 citation statements)

References 23 publications

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“…Theoretically, drugeluting stents may have an increased risk for infection due to the delayed covering by endothelial cells, and thereby, favoring bacterial adherence. However, coronary stent infection is extremely rare, and drug-eluting stents have not been shown to be at increased risk for infection [142][143][144].…”

Section: Intracellular Persistence Of Bacteria In Implant-associated mentioning

confidence: 99%

Pathogenesis of implant-associated infection: the role of the host

2011

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Implanted devices are mainly used to improve impaired function or to replace missing anatomic structures. They are made of synthetic material or devitalized biological structures. In contrast to vital transplants, they are not rejected by the body. However, the host reacts against these foreign bodies, a process which can be designated as biocompatibility. The interaction of the device with adjacent granulocytes and complement not only induces various degrees of inflammation but also impairs local microbial clearance. Foreign surfaces are a preferred target for bacterial adherence. While adhering bacteria are highly resistant to the bactericidal activity of phagocytes, they are also resistant to most antimicrobial agents. Certain bacteria may reside within host cells, and hence, evade host defense mechanisms by persisting intracellularly around implants. Nanotechnology minimizes clotting activation and bacterial adhesion by intravascular devices. Furthermore, surface coating with appropriate substances favorably influences biocompatibility as well as susceptibility to infection. In the future, "Microsystems Technology" deployed as intelligent device may decrease the risk of implant failure due to infection.

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Section: Intracellular Persistence Of Bacteria In Implant-associated mentioning

confidence: 99%

Pathogenesis of implant-associated infection: the role of the host

2011

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“…Although millions of coronary stents have been placed, a little more than a dozen infections were reported [85][86][87]. Endothelialization of the stent has been suggested to prevent infection [7].…”

Section: Coronary Artery Stentsmentioning

confidence: 99%

“…Complications like septic emboli, mycotic coronary aneurysm, and purulent pericarditis have been described [85,86,89]. The diagnosis of this rare infection and its complications is usually accomplished by using TTE, TEE, computed tomography, magnetic resonance imaging, and magnetic resonance angiogram [7,85,86,89].…”

Section: Coronary Artery Stentsmentioning

confidence: 99%

Cardiovascular Implantable Device Infections

Viola

Darouiche

2011

Curr Infect Dis Rep

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As life expectancy continues to increase and biotechnology advances, the use of cardiovascular implantable devices will continue to rise. Unfortunately, despite modern medical advances, the infection and mortality rates remain excessively elevated. This article reviews the pathophysiology and general concepts of cardiac device-related infections, including the physical and chemical characteristics of the medical device, host response to the medical device, and the microbiologic virulence factors. Infections of the most commonly utilized cardiovascular implantable devices, including cardiovascular implantable electronic devices, bioprosthetic and mechanical valves, ventricular assist devices, total artificial hearts, and coronary artery stents, are reviewed in detail.

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“…In fact, although drug-eluting stents have resulted in lower percentages of reatherosclerosis in affected coronaries, emerging data from a few animal studies have recently raised concern about these new-age stents causing significant granulomatous inflammatory response, progressing to vascular remodeling [16]. Stent infection represents an uncommon complication related to bacteremia after the intervention, and patients can develop pericardial effusions and coronary false or true aneurysms [17]. In our patient, coronary arteritis resulted in myocardial abscesses.…”

Section: Discussionmentioning

confidence: 71%