Hii Michael, Lin Richard, Waugh Joseph, Clarke Nicholas, Bate Alexander, Viana Fabiano, Nelson Adam
Royal Adelaide Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, Australia.
Royal Adelaide Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, Australia.
JACC Case Rep. 2025 Mar 19;30(6 Pt 1):102822. doi: 10.1016/j.jaccas.2024.102822. Epub 2025 Jan 8.
We present a case of coronary stent infection, an exceptionally rare complication following percutaneous coronary intervention associated with a high rate of morbidity and mortality. A 75-year-old woman presented with non-ST-segment elevation myocardial infarction who underwent percutaneous coronary intervention to a saphenous vein graft uneventfully. She re-presented with signs and symptoms of infection with growth of Staphylococcus aureus in blood culture. Multimodality imaging including 18F-fluorodeoxyglucose positron emission tomography-computed tomography and computed tomography angiography-confirmed coronary stent infection. The patient underwent redo cardiac surgery due to mycotic aneurysm formation. Coronary stent infection requires a high index of suspiscion to diagnose and the use of multimodality imaging and multidisciplinary approaches to manage this rare complication are essential. Despite this, the mortality rate is high at 18% to 44% reported in other series due to local complications such as mycotic aneurysm formation as in this case.
我们报告一例冠状动脉支架感染病例，这是经皮冠状动脉介入治疗后极为罕见的并发症，其发病率和死亡率很高。一名75岁女性因非ST段抬高型心肌梗死就诊，接受了大隐静脉移植血管的经皮冠状动脉介入治疗，过程顺利。她再次出现感染的体征和症状，血培养发现金黄色葡萄球菌生长。包括18F-氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描和计算机断层血管造影在内的多模态成像证实了冠状动脉支架感染。由于霉菌性动脉瘤形成，患者接受了再次心脏手术。冠状动脉支架感染需要高度怀疑才能诊断，使用多模态成像和多学科方法来处理这种罕见并发症至关重要。尽管如此，其他系列报道显示，由于如本例中的霉菌性动脉瘤形成等局部并发症，死亡率高达18%至44%。
