Infections related to coils used for embolization of arteries: review of the published evidence.

The embolization of arteries with the use of coils has been an advance in the management of patients such as those at risk for aneurysm rupture. However, this procedure is not without complications. A systematic review was undertaken to evaluate the available evidence regarding infectious complications directly related to endovascular coil embolization. Seven case reports of patients who experienced infection related to coils used for embolization of arteries were discovered. Arteries embolized with coils in these patients were intracranial, intraabdominal, and intrathoracic, respectively, in four, two, and one case. Abscess formation in the area of coil placement (n = 6; 85.7%) was the most common infectious complication directly related to endovascular coil embolization. Staphylococcus aureus was the predominant isolated pathogen (n = 3; 42.9%). Other isolated pathogens included Salmonella species type D (n = 1; 14.3%), S. epidermidis (n = 1; 14.3%), Escherichia coli (n = 1; 14.3%), and Bacteroides fragilis (n = 1; 14.3%). Surgical procedures were performed in four of the seven patients described (57.1%), and three patients were treated with only the administration of antimicrobial agents. All reviewed patients were cured. Even though it may partially be a result of reporting bias, the scarcity of reports describing infections directly related to endovascular coils despite the increasing number of patients who received this treatment in various parts of the world suggests that infectious complications associated with this foreign endovascular material are very rare. However, the existence of the identified case reports suggests that clinicians should include coil-related infection in the differential diagnosis of patients with fever after this procedure.