Late Silent Stent Abscess
Autor: | Elvira Fattakhova, Vladimir Demchinsky, Tatiana Baklanova, Victor L. Serebruany, Dmitry Zateyshchikov |
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Rok vydání: | 2015 |
Předmět: |
Male
Bare-metal stent medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Chest pain Electrocardiography Postoperative Complications medicine.artery Angioplasty Coronary stent medicine Humans Pharmacology (medical) Myocardial infarction Angioplasty Balloon Coronary Cardiac catheterization business.industry Stent Middle Aged medicine.disease Abscess Surgery Right coronary artery Stents medicine.symptom Cardiology and Cardiovascular Medicine business |
Zdroj: | Cardiology. 132:65-67 |
ISSN: | 1421-9751 0008-6312 |
Popis: | Background: Coronary stent infections in general and stent abscesses (SAs) in particular are rare but often deadly complications. Most SAs manifest with fever and chest pain within 30 days after intervention and require antibiotics and stent removal. Case Report: A 45-year-old man with second ST elevated myocardial infarction and cardiogenic shock was admitted to a hospital that had no cardiac catheterization laboratory. The patient underwent fibrinolytic therapy with alteplase but died 1 h later. His medical history revealed posterior myocardial infarction 7 years before, which had been successfully treated with a bare metal stent of the right coronary artery. The post-discharge observation had been unremarkable with no evidence of ischaemia or infection but gross non-compliance. Autopsy revealed complete closure of the left main coronary artery and a surprise additional finding, namely SA; the stented portion of the artery was enveloped by an abscess, and purulent material completely occluded the stent, which was floating in pus. Impressions: Since coronary angioplasty is so common, the incidence of late silent SA is probably higher than expected, especially considering that there is often a lack of clinical manifestations. Clinicians should be cognizant of this complication. More attention may be required to assess the condition of existing stents during repeated interventions. Gross non-compliance and/or early withdrawal from dual anti-platelet therapy may be directly responsible for the development of silent delayed SA. |
Databáze: | OpenAIRE |
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