Effect of antibiotic treatment in patients with postimplantation syndrome after aortic stent placement

Abstract

Introduction and objectives: Postimplantation syndrome that can develop after stent placement is characterized by fever, leukocytosis and an elevated C-reactive protein level or by coagulation disturbances, or by a combination of these features. It is a transient condition that frequently appears following endovascular treatment. At present, no data are available on the effect of antibiotics on postimplantation syndrome after placement of a thoracic endoprosthesis.

Methods: This prospective single-center study involved 40 patients. Of these, 20 received peri-interventional (for 24 hours) antibiotic treatment with cefuroxime, 20 mg/ kg three times per day, while 20 received prolonged (for 7 days) treatment at the same dosage. Peripheral blood samples were taken before the intervention and 6 h, 12 h, 24 h, 48 h, 3 days, 5 days, and 7 days after.

Results: There was no significant difference in clinical or laboratory findings between the two treatment strategies, and subsequent changes in clinical and laboratory parameters over time were similar in the two groups. All parameters returned to baseline values within 7 days.

Conclusions: Prolonging antibiotic treatment beyond the day of endovascular intervention was not observed to provide any short- or long-term clinical benefit in patients with postimplantation syndrome, given that all blood samples were sterile.