Mycotic pseudoaneurysm of the left circumflex coronary artery: a fatal complication following drug-eluting stent implantation.
Coronary artery stent infection is a rare complication of percutaneous intervention. We report a case of fulminant coronary stent infection with Staphylococcus aureus presenting as a pseudoaneurysm of the left circumflex artery following repeated implantation of drug-eluting stents in the setting of multiple episodes of recurrent in-stent restenosis. We speculate that sirolimus- and paclitaxel-eluting stents may be more likely to predispose to infection than bare metal stents because of their immunomodulating and antiproliferative effects.
Le
Mimi Q
MQ
Division of Cardiology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.
Narins
Craig R
CR
D000368:Aged; D017541:Aneurysm, False / Q000209:etiology* / Q000382:microbiology; D000785:Aneurysm, Infected / Q000209:etiology* / Q000382:microbiology; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D002317:Cardiovascular Agents / Q000009:adverse effects; D049109:Cell Proliferation / Q000187:drug effects; D023903:Coronary Restenosis / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D017239:Paclitaxel / Q000009:adverse effects; D016459:Prosthesis-Related Infections / Q000209:etiology; D020123:Sirolimus / Q000009:adverse effects; D013203:Staphylococcal Infections / Q000209:etiology*; D013211:Staphylococcus aureus; D015607:Stents / Q000009:adverse effects*
D002317:Cardiovascular Agents; D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus