Spontaneous coronary artery perforation secondary to a sirolimus-eluting stent infection.
Coronary stent infection is exceedingly rare despite the widespread use of percutaneous coronary intervention (PCI). The utilization of drug-eluting stents (DES) may have a higher theoretical risk of infection due to their local immunosuppressant effect. Vigilance in suspecting stent infection is important, as the associated mortality rate is approximately 50%. We discuss the case of a patient who presented with an infected DES 2 weeks after implantation which led to spontaneous Type II coronary perforation. The perforation was sealed with prolonged balloon inflation, and the patient was treated with intravenous antibiotics. This is the first reported case of a patient with a stent infection who presented with a spontaneous coronary perforation.
Garg
Ravi K
RK
Section of Cardiology, Research Medical Center, Kansas City Cardiology, 6420 Prospect Avenue, T-509, Kansas City, MO 64132, USA. ravi.garg@kchf.org
Sear
James E
JE
Hockstad
Eric S
ES
D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004452:Echocardiography; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016459:Prosthesis-Related Infections / Q000175:diagnosis*; D012422:Rupture, Spontaneous; D020123:Sirolimus / Q000009:adverse effects*; D013203:Staphylococcal Infections / Q000209:etiology
D007166:Immunosuppressive Agents; D020123:Sirolimus