Perivascular Inflammatory Reaction to a Hemobahn Stent-Graft: Diagnosis with 3D MR Angiography

Abstract

Purpose: To present a rare perivascular inflammatory reaction to a commercially produced polytetrafluoroethylene-covered stent and demonstrate the utility of 3-dimensional (3D) magnetic resonance angiography (MRA) in the diagnosis of this phenomenon. Case Report: Three weeks after percutaneous deployment of a Hemobahn stent-graft to treat a high-grade stenosis and aneurysm of the proximal left superficial femoral artery (SFA), a 70-year-old diabetic man developed fever, pain, and local swelling of the left thigh. Venous thrombosis was excluded by ultrasound imaging; a normal flow profile was seen in the left common and superficial femoral arteries. Blood analysis found elevated inflammatory markers. MRA revealed extensive soft-tissue edema and perivascular contrast enhancement around the left SFA, but the stent-graft was patent. The clinical symptoms resolved within 7 days after initiation of anti-inflammatory therapy. Follow-up MRA scans demonstrated significantly reduced inflammatory reaction over the next few months. Conclusions: Symptomatic perivascular inflammatory soft-tissue response to a stent-graft can be diagnosed with MR imaging studies.