{"title":"支架感染导致冠状动脉瘤和冠状动脉瘤腔内瘘。","authors":"Sathish Kumar Rentapalla MD , Barun Kumar MD, DM , Anirudh Mukherjee MD, DM , Pradeep Kumar MS, MCH","doi":"10.1016/j.jaccas.2025.104125","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Coronary stent infection (SI) is a rare but catastrophic complication, occurring in 0.3% to 6% of cases post–percutaneous coronary intervention (PCI). Early diagnosis and surgical interventions are crucial for definitive diagnosis and management.</div></div><div><h3>Case Summary</h3><div>A 52-year-old man underwent PCI for an inferior wall myocardial infarction to the left circumflex artery (LCx) with a single sirolimus-eluting stent. He developed a fever 10 days later due to methicillin-sensitive <em>Staphylococcus aureus</em>. Imaging showed a coronary cameral fistula with a left atrial appendage (LAA) mycotic aneurysm. He was treated with antibiotics, stent explantation, abscess drainage, and fistula repair; however, he developed refractory vasoplegia and died 2 days post-surgery.</div></div><div><h3>Discussion</h3><div>Coronary SI requires a high index of suspicion. The use of multimodality imaging and multidisciplinary approaches to diagnose and manage infection is essential. Late and complicated stent infections have a high mortality rate.</div></div><div><h3>Take-Home Messages</h3><div>Coronary SI is an important differential diagnosis for fever post-PCI. Prompt diagnosis, multimodality imaging, and early intervention are needed.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 30","pages":"Article 104125"},"PeriodicalIF":0.0000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Stent Infection Leading to Coronary Aneurysm and Coronary Cameral Fistula\",\"authors\":\"Sathish Kumar Rentapalla MD , Barun Kumar MD, DM , Anirudh Mukherjee MD, DM , Pradeep Kumar MS, MCH\",\"doi\":\"10.1016/j.jaccas.2025.104125\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Coronary stent infection (SI) is a rare but catastrophic complication, occurring in 0.3% to 6% of cases post–percutaneous coronary intervention (PCI). Early diagnosis and surgical interventions are crucial for definitive diagnosis and management.</div></div><div><h3>Case Summary</h3><div>A 52-year-old man underwent PCI for an inferior wall myocardial infarction to the left circumflex artery (LCx) with a single sirolimus-eluting stent. He developed a fever 10 days later due to methicillin-sensitive <em>Staphylococcus aureus</em>. Imaging showed a coronary cameral fistula with a left atrial appendage (LAA) mycotic aneurysm. He was treated with antibiotics, stent explantation, abscess drainage, and fistula repair; however, he developed refractory vasoplegia and died 2 days post-surgery.</div></div><div><h3>Discussion</h3><div>Coronary SI requires a high index of suspicion. The use of multimodality imaging and multidisciplinary approaches to diagnose and manage infection is essential. Late and complicated stent infections have a high mortality rate.</div></div><div><h3>Take-Home Messages</h3><div>Coronary SI is an important differential diagnosis for fever post-PCI. Prompt diagnosis, multimodality imaging, and early intervention are needed.</div></div>\",\"PeriodicalId\":14792,\"journal\":{\"name\":\"JACC. Case reports\",\"volume\":\"30 30\",\"pages\":\"Article 104125\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JACC. Case reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666084925009064\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC. Case reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666084925009064","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Stent Infection Leading to Coronary Aneurysm and Coronary Cameral Fistula
Background
Coronary stent infection (SI) is a rare but catastrophic complication, occurring in 0.3% to 6% of cases post–percutaneous coronary intervention (PCI). Early diagnosis and surgical interventions are crucial for definitive diagnosis and management.
Case Summary
A 52-year-old man underwent PCI for an inferior wall myocardial infarction to the left circumflex artery (LCx) with a single sirolimus-eluting stent. He developed a fever 10 days later due to methicillin-sensitive Staphylococcus aureus. Imaging showed a coronary cameral fistula with a left atrial appendage (LAA) mycotic aneurysm. He was treated with antibiotics, stent explantation, abscess drainage, and fistula repair; however, he developed refractory vasoplegia and died 2 days post-surgery.
Discussion
Coronary SI requires a high index of suspicion. The use of multimodality imaging and multidisciplinary approaches to diagnose and manage infection is essential. Late and complicated stent infections have a high mortality rate.
Take-Home Messages
Coronary SI is an important differential diagnosis for fever post-PCI. Prompt diagnosis, multimodality imaging, and early intervention are needed.