Aeschbacher B C, Meier B
Kardiologische Abteilung, Medizinische Universitätsklinik, Inselspital Bern, Schweiz.
Vasa. 1994;23(3):257-60.
Percutaneous coronary interventional procedures exhibit an increased risk of peripheral vascular complications compared with diagnostic coronary angiography. Septic complications affect typically the puncture site. We describe a septic event (staphylococcus aureus) resulting in a mycotic aneurysm of the iliacal artery with embolic gonarthritis after a prolonged percutaneous transluminal coronary angioplasty performed 13 days after diagnostic coronary angiography using the same vascular access. The presumed culprit was the reintroduced dilatator which must have been contaminated. An emergency resection of the aneurysm and implantation of a Gore-Tex crossover bypass had to be performed. With prolonged parenteral and enteral antibiotic treatment the infection was controlled. We discuss risk factors for septic complications after coronary interventions and possible preventive measures.
与诊断性冠状动脉造影相比，经皮冠状动脉介入手术出现外周血管并发症的风险更高。感染性并发症通常影响穿刺部位。我们描述了1例感染事件（金黄色葡萄球菌），在诊断性冠状动脉造影后13天，使用相同血管通路进行了长时间的经皮腔内冠状动脉成形术，结果导致髂动脉霉菌性动脉瘤并伴有栓塞性膝关节炎。推测罪魁祸首是再次使用的扩张器，它肯定已被污染。不得不紧急切除动脉瘤并植入戈尔特斯交叉旁路。通过长时间的肠外和肠内抗生素治疗，感染得到了控制。我们讨论了冠状动脉介入术后感染性并发症的危险因素及可能的预防措施。
