Pararenal aortic pseudoaneurysm secondary to renal stent infection

TL;DR

A rare case of a kidney stent infection led to a dangerous aortic pseudoaneurysm, requiring complex surgery and long-term treatment.

Contribution

Highlights a rare complication of renal stent infection and the challenges in managing pararenal aortic pseudoaneurysms.

Findings

Staphylococcus lugdunensis infection of a covered stent caused a pararenal aortic pseudoaneurysm.

Open surgical repair was necessary due to anatomical and clinical limitations for endovascular treatment.

The case underscores the importance of antibiotic prophylaxis and individualized surgical planning in such rare infections.

Abstract

This report presents a case of a 57-year-old woman with protein C deficiency who developed a renal artery covered stent infection owing to Staphylococcus lugdunensis infection, resulting in a pararenal aortic pseudoaneurysm. She had previously undergone a thrombectomy and covered stent placement owing to renal artery thrombosis before developing recurrent thrombosis, infection, and a pseudoaneurysm. She required open repair with nephrectomy, aortic debridement, rifampin-soaked Dacron patch angioplasty, and a prolonged antibiotic course. Her anatomy and clinical presentation precluded endovascular options, highlighting the complexity of such cases. This report emphasizes the need for heightened awareness of rare stent infections, individualized surgical planning, and the importance of antibiotic prophylaxis during endovascular procedures.

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