Yonsei Med J.  2017 Mar;58(2):458-461. 10.3349/ymj.2017.58.2.458.

Coronary Stent Infection Presented as Recurrent Stent Thrombosis

• Lai CH
• Lin YK
• Lee WL
• Chang WC

• KMID: 2427138
• DOI: http://doi.org/10.3349/ymj.2017.58.2.458

Abstract

Percutaneous transluminal coronary angioplasty with metal stent placement has become a well-developed treatment modality for coronary stenotic lesions. Although infection involving implanted stents is rare, it can, however, occur with high morbidity and mortality. We describe herein a case of an inserted coronary stent that was infected and complicated with recurrent stent thrombosis, pseudoaneurysm formation and severe sepsis. Despite repeated intervention and bypass surgery, the patient died from severe sepsis.

Keyword

Stent infection; pseudoaneurysm; stent thrombosis; graft stent; acute myocardial infarction

MeSH Terms

Angioplasty, Balloon, Coronary/*adverse effects
Coronary Stenosis/*therapy
Fatal Outcome
Humans
Metals
Recurrence
Sepsis/*etiology
Stents/*adverse effects
Thrombosis/*etiology
Treatment Outcome
Metals

Figure

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  Fig. 1 Serial angiography of first time intervention. (A) Right oblique caudal view of left coronary artery shows severe stenosis of distal left main (LM, arrow) and proximal left circumflex artery. (B) Diffuse stenosis and distal total occlusion of right coronary artery (RCA). (C) Angiography of RCA after stenting. (D) Stent deployed from LM to proximal left anterior descending artery (arrow). (E) Right oblique caudal view of left coronary artery after stenting (arrow: LM stenting). (F) Spider view of left coronary artery after stenting.

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  Fig. 2 (A, B, and C) Emergent angioplasty for first time stent thrombosis. (D) Emergent angioplasty for second time stent thrombosis. (E and F) Putting a graft stent. (A) Right oblique cranial view of left coronary artery shows stent thrombosis in proximal LAD (arrowheads) and pseudoaneurysm in distal LM (arrow). (B) Spider view of left coronary artery shows coronary pseudoaneurysm in distal LM (arrow). (C) Material from manual thrombus aspirator reveals thrombi with pus like material (arrow). (D) One day later, emergent angiography shows recurrent in stent thrombosis (arrowheads) and progression of coronary pseudoaneurysm in distal LM (arrow). (E) Graft stent being inserted from LM to proximal LAD (stent margin marked as arrowheads) to cover coronary pseudoaneurysm (arrow). (F) After inserting graft stent, angiography of left coronary artery reveals complete jailing of LCX. LAD, left anterior descending artery; LM, left main; LCX, left circumflex artery.

Reference

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