Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital.
Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
Coron Artery Dis. 2022 Jun 1;33(4):318-326. doi: 10.1097/MCA.0000000000001098. Epub 2021 Sep 3.
Coronary stent infection (CSI) is the rarest complication associated with the percutaneous coronary intervention, occurring in less than 0.1% of cases. So far, all reported instances are limited to case reports. CSI presents itself in various, often confusing, ways in clinical settings. Therefore, the current systematic review summarizes reports of CSI's clinical presentations, causative pathogens, diagnoses and treatments. This systematic review considered three online databases, using reference lists as an additional source. All case reports or case series with stent infection in the coronary artery were included - however, reviews or commentaries, articles not published in English, and articles mentioning a history of hemodialysis or any surgery were excluded. Thirty-two studies on 34 CSI patients were included in the final qualitative analysis. CSI predominantly affected males of a wide range of ages. The most common symptoms were chest pain and fever with various onsets. Interestingly, CSI usually occurred during the first stent implantation. Cultures and coronary angiography were the most common methods used to diagnose CSI. Furthermore, drug-eluting stents had a higher risk of infection than bare-metal stents. Aneurysms were the most frequent abnormalities observed in infected stents. The bacteria that most often caused CSI were Staphylococcus aureus and Pseudomonas aeroginosa. More than 90% of the reports mentioned using various antibiotics, and 74% mentioned carrying out surgery. Finally, a mortality rate of 26.47% among CSI patients was calculated.
冠状动脉支架感染（CSI）是经皮冠状动脉介入治疗中最罕见的并发症，发生率低于 0.1%。到目前为止，所有报告的病例都仅限于病例报告。CSI 在临床环境中以各种（通常令人困惑的）方式表现出来。因此，本系统综述总结了 CSI 的临床表现、病原体、诊断和治疗的报告。本系统综述考虑了三个在线数据库，并将参考文献列表作为额外的来源。所有报告的冠状动脉支架感染的病例报告或病例系列都被包括在内——然而，综述或评论、非英文发表的文章以及提到血液透析史或任何手术史的文章被排除在外。最终的定性分析纳入了 34 名 CSI 患者的 32 项研究。CSI 主要影响年龄范围广泛的男性。最常见的症状是胸痛和发热，起病方式各异。有趣的是，CSI 通常发生在第一次支架植入期间。培养和冠状动脉造影是诊断 CSI 最常用的方法。此外，药物洗脱支架比裸金属支架感染的风险更高。感染支架中最常见的异常是动脉瘤。最常引起 CSI 的细菌是金黄色葡萄球菌和铜绿假单胞菌。超过 90%的报告提到使用各种抗生素，74%的报告提到进行手术。最后，计算出 CSI 患者的死亡率为 26.47%。
