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Updated: Aug 8, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Endovascular stent infection with delayed bacterial challenge
A T Hearn1, K V James, J M Lohr
1John J. Cranley Vascular Laboratory, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA.
Background:
Reports of endovascular stent infection have recently been described. The purpose of this study was to determine if intravascular metallic stents in a swine model could become infected following a bacterial challenge given remote from the time of stent placement.
Methods:
Balloon expandable metallic stents (Palmaz) were implanted in the iliac arteries of 14 swine. An angioplasty, without stent placement, was also performed in the contralateral iliac artery. An intravenous bacterial challenge with Staphylococcus aureus was given 4 weeks after stent placement. Euthanasia was performed 72 hours after the bacterial challenge. At the time of euthanasia, the iliac artery/stent complex and the contralateral angioplastied iliac artery were harvested and sent for microbiologic and pathologic analysis.
Results:
Seven of the 14 stent/artery complexes were culture positive for S aureus whereas only one of the 14 angioplastied arteries was positive for S aureus (P = 0.03). On histologic examination, 6 of the 14 stent/artery complexes had evidence of acute inflammatory changes in the arterial wall. This compares with only 1 of 14 angioplastied arteries having evidence of inflammatory infiltrate in the arterial wall (P = 0.07). All 6 of the stent/artery complexes with inflammatory infiltrate were culture positive.
Conclusion:
In the swine model, intravascular metallic stents have the potential to become infected when a bacterial challenge is given 4 weeks after stent placement. Further studies evaluating the incidence of stent infections in humans are needed.
Insights
Metallic stents implanted in swine iliac arteries showed a higher infection rate with Staphylococcus aureus when challenged four weeks later. This swine model suggests intravascular metallic stents can become infected post-placement.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Biomedical Engineering
Background:
- Endovascular stent infections are an emerging clinical concern.
- Understanding the potential for stent infection is crucial for patient safety.
Purpose of the Study:
- To investigate the susceptibility of intravascular metallic stents to infection in a swine model.
- To assess infection risk following a delayed bacterial challenge after stent implantation.
Main Methods:
- Metallic stents (Palmaz) were placed in swine iliac arteries, with angioplasty alone in the contralateral artery.
- A bacterial challenge with Staphylococcus aureus was administered intravenously four weeks post-stent placement.
- Iliac artery/stent complexes and control arteries were analyzed microbiologically and pathologically after 72 hours.
Main Results:
- Stent/artery complexes showed significantly higher S. aureus culture positivity (7/14) compared to angioplastied arteries (1/14, P=0.03).
- Histological analysis revealed acute inflammatory changes in 6/14 stent/artery complexes versus 1/14 control arteries (P=0.07).
- All stent/artery complexes with inflammation were culture-positive for S. aureus.
Conclusions:
- Intravascular metallic stents in swine are susceptible to infection when challenged with bacteria four weeks after implantation.
- These findings highlight the potential for delayed stent infections.
- Further human studies are warranted to determine the clinical incidence of stent infections.
