Mando Nur, Short Lillian, Habeb Bola, Mouselli Asaad, Valdes Otto, Amin Rohit, Antonious Daniel
Internal Medicine, University of Florida College of Medicine/Ascension Sacred Heart, Pensacola, USA.
Cardiology, Ascension Sacred Heart, Pensacola, USA.
Cureus. 2025 Aug 10;17(8):e89728. doi: 10.7759/cureus.89728. eCollection 2025 Aug.
The incidence of infective endocarditis (IE) has risen globally, with intravenous drug use contributing significantly to its increasing prevalence. IE can lead to severe complications, including embolic stroke, heart failure, and septic embolization, often resulting in high morbidity and mortality. While traditional treatment involves long-term antibiotics and surgery, some patients are poor surgical candidates and require alternative interventions. This case report presents a 50-year-old woman who developed methicillin-resistant tricuspid valve endocarditis complicated by persistent bacteremia and septic emboli. Due to her inoperability, she underwent successful percutaneous mechanical thrombectomy using the Penumbra Lightning Flash 2.0 system (Penumbra, Inc., Alameda, CA). The Penumbra Lightning Flash 2.0 device offers a less invasive, effective method for debulking endocarditis vegetations, reducing procedural risks, such as blood loss, and requiring fewer resources than other thrombectomy devices like the AngioVac system. This case demonstrates the potential of the Lightning Flash 2.0 as a safer, more accessible treatment option for patients with difficult-to-manage IE who cannot undergo surgery.
感染性心内膜炎（IE）的发病率在全球范围内呈上升趋势，静脉注射毒品的使用对其患病率的上升有显著影响。IE可导致严重并发症，包括栓塞性中风、心力衰竭和脓毒性栓塞，常常导致高发病率和死亡率。虽然传统治疗包括长期使用抗生素和手术，但一些患者不适合手术，需要采取替代干预措施。本病例报告介绍了一名50岁女性，她患耐甲氧西林三尖瓣心内膜炎，并发持续性菌血症和脓毒性栓子。由于她无法进行手术，她使用Penumbra Lightning Flash 2.0系统（Penumbra公司，加利福尼亚州阿拉米达）成功接受了经皮机械血栓切除术。Penumbra Lightning Flash 2.0装置提供了一种侵入性较小、有效的方法来清除心内膜炎赘生物，降低手术风险，如失血，并且比AngioVac系统等其他血栓切除装置需要的资源更少。本病例证明了Lightning Flash 2.0作为一种更安全、更易获得的治疗选择，对于无法接受手术的难治性IE患者的潜力。
