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病例报告:冠状动脉内支架断裂并发冠状动脉脓肿及心包瘘形成。

Case report: intracoronary stent fracture complicated with coronary abscess and fistulization into the pericardium.

作者信息

Rusali Constantin Andrei, Cojocaru Lucia, Șerbanescu Ioana Caterina, Scupra Valentin, Iurco Daniela

机构信息

Faculty of Medicine, Ovidius University of Constanta, Campus, University Alley, No 1, Building B, 900470 Constanta, Romania.

Constanta County Clinical and Emergency Hospital, Cardiology Clinic, Tomis Boulevard No 145, 3rd floor, 900591 Constanta, Romania.

出版信息

Eur Heart J Case Rep. 2024 Sep 27;8(10):ytae532. doi: 10.1093/ehjcr/ytae532. eCollection 2024 Oct.

DOI:10.1093/ehjcr/ytae532
PMID:39450322
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11500811/
Abstract

BACKGROUND

Stent fractures are a rare complication of angioplasties and are an unusual substrate for coronary abscesses.

CASE SUMMARY

A 63-year-old patient came into the emergency department for ongoing chest pain. The patient had recently undergone coronary stent implantation, 3 months prior. Computed tomography coronary angiography revealed a coronary abscess and stent fracture, with blood effraction into the pericardium. The patient underwent emergency open-heart surgery to clear the infection and perform coronary artery bypass graft surgery. Post-operative outcome was tentatively favourable. The patient suffered acute kidney injury and required haemodialysis.

DISCUSSION

Coronary stent fracture is a rare complication which can be life-threatening and which can lead to severe sequelae.

摘要

背景

支架断裂是血管成形术的一种罕见并发症,也是冠状动脉脓肿的不常见病因。

病例摘要

一名63岁患者因持续胸痛进入急诊科。该患者3个月前刚接受冠状动脉支架植入术。计算机断层扫描冠状动脉造影显示冠状动脉脓肿和支架断裂,血液渗入心包。患者接受了急诊心脏直视手术以清除感染并进行冠状动脉旁路移植术。术后初步结果良好。患者出现急性肾损伤,需要进行血液透析。

讨论

冠状动脉支架断裂是一种罕见的并发症,可能危及生命并导致严重后遗症。

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本文引用的文献

1
Incidence of coronary drug-eluting stent fracture: A systematic review and meta-analysis.冠状动脉药物洗脱支架断裂的发生率:一项系统评价与荟萃分析。
Front Cardiovasc Med. 2022 Aug 23;9:925912. doi: 10.3389/fcvm.2022.925912. eCollection 2022.
2
Coronary stent infection: a systematic review.冠状动脉支架感染:系统评价。
Coron Artery Dis. 2022 Jun 1;33(4):318-326. doi: 10.1097/MCA.0000000000001098. Epub 2021 Sep 3.
3
Case Report: Coronary artery stent infection with mycotic aneurysm secondary to tricuspid valve infective endocarditis.
病例报告:三尖瓣感染性心内膜炎继发冠状动脉支架感染并霉菌性动脉瘤
F1000Res. 2019 Jun 12;8:853. doi: 10.12688/f1000research.19067.1. eCollection 2019.
4
Coronary stent infection: Interesting cases with varied presentation.冠状动脉支架感染:表现各异的有趣病例。
J Cardiol Cases. 2018 Sep 12;19(1):5-8. doi: 10.1016/j.jccase.2018.08.004. eCollection 2019 Jan.
5
Coronary Stent Infection Presented as Recurrent Stent Thrombosis.以复发性支架内血栓形成表现的冠状动脉支架感染
Yonsei Med J. 2017 Mar;58(2):458-461. doi: 10.3349/ymj.2017.58.2.458.
6
Coronary stent fracture: a recently appreciated phenomenon with clinical relevance.冠状动脉支架断裂:一种最近才被认识到的具有临床相关性的现象。
Curr Cardiol Rev. 2014 Nov;10(4):349-54. doi: 10.2174/1573403x10666140404105923.
7
Stent fracture, an incidental finding or a significant marker of clinical in-stent restenosis?支架断裂,是偶然发现还是支架内临床再狭窄的重要标志?
Catheter Cardiovasc Interv. 2008 Apr 1;71(5):614-8. doi: 10.1002/ccd.21371.