A curious case of stent fracture and left ventricular pseudoaneurysm – A rare association in the background of cardiac tuberculosis

Mani, Avinash; Harikrishnan, Sreedharan; Valaparambil, Ajit Kumar

doi:10.1177/00494755211017422

Cited by 2 publications

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References 1 publication

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“…Furthermore, complete SF is associated with the formation of coronary aneurysm [ 10 , 45 ]. As a side note, occasional case reports have been published showing SF as a complication of post-stenting pyogenic infections and mycotic coronary pseudoaneurysm [ 54 , 55 ]. Furthermore, an infected SF-induced coronary artery aneurysm has been described as a highly probable origin for formation of abscesses and sepsis with Staphylococcus aureus [ 56 , 57 ].…”

Section: Reviewmentioning

confidence: 99%

Coronary Stent Fracture Causing Myocardial Infarction: Case Report and Review of Literature

Gröger¹,

Rottbauer²,

Keßler³

2022

Rev. Cardiovasc. Med.

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Coronary stent fracture (SF) is a potential cause of stent failure increasing the risk for in-stent restenosis, stent thrombosis, target lesion revascularization and major adverse cardiac events. Overall incidence of SF ranges from <1.0% up to 18.6% and SF can be found in up to 60% of failed devices. Advanced imaging techniques have improved the detection of SF. However, defining the optimal therapeutic approach towards these complex lesions is challenging. This review summarizes the most important publications on the topic of SF and discusses current insights into pathophysiology, diagnostic tools, classification and therapeutic management. Furthermore, two illustrative cases of SF leading to myocardial infarction are presented, which demonstrate typical SF risk factors such as vessel angulation and hinge motion, stenting in the right coronary artery, use of long stents and multiple stent layers.

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Section: Reviewmentioning

confidence: 99%

Coronary Stent Fracture Causing Myocardial Infarction: Case Report and Review of Literature

Gröger¹,

Rottbauer²,

Keßler³

2022

Rev. Cardiovasc. Med.

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Clinical characteristic and imaging findings of post-infarction left ventricular pseudoaneurysm versus aneurysm: a pooled analysis of 21,472 patients

Afshar

Tayebi

Samimisedeh

et al. 2023

Preprint

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Background Left ventricular pseudoaneurysm (LVPA) is a rare but life-threatening complication of myocardial infarction (MI). Given the similarities in the clinical presentations and the appearance of the cardiac imaging, differentiation of LVPA from left ventricular aneurysm (LVA) remains a challenge but is imperative for timely management. We summarized and compared clinical and imaging findings of post-MI LVPA and LVA. Method We performed a comprehensive search of the literature in PubMed and Scopus databases using combinations of key terms covering LVPA / LVA and MI. In both LVA and LVPA, individual-level patient data (IPD) and aggregated-level data (AD) studies were combined through a two-stage analysis method. Results We identified 379 eligible articles on LVPA (N= 504 patients) and 120 on LVA (n= 20,968). Based on our pooled analysis, cases were predominantly male in both groups (70.4%and 75.7 %, respectively), but LVPA patients were roughly older (Mean (95% Confidence interval (CI): (65.4 (62.4, 68.4) vs. 60.8 (58.9, 62.8) years, respectively) and had a shorter mean time interval from MI to diagnosis than LVA (5.1 vs. 27.8, months). At presentation, while 33.8 (95% CI: 22.1, 46.0) of patients with LVA had arrhythmia, only 1.0 % (95% CI: 0.0, 2.9) of LVPA patients presented with this symptom. LVPA compared to the LVA group, more frequently had ST-segment elevation (43.2% Vs. 28.6, respectively) but less frequently ECG signs of the old MI (42.2% Vs. 61.9, respectively). Echocardiography showed a lower diagnostic value in LVPA than LVA (Sensitivity: 81.4% Vs. 97.5%). Contrary to LVA, LVPA is mainly located on posterior and inferior segments based on echocardiography evaluations. On Cardiac MRI, the majority of LVPA patients had pericardial LGE (84.0% (CI 95%: 63.9, 95.5)). A higher percentage of LVPA compared to the LVA group dead during hospitalization (13.8% vs. 4.7%, respectively) or after discharge (17.5%vs. vs. 9.0%, respectively). Conclusion Arrhythmia is likely common in LVA patients at presentation but not in LVPA. LVPA is mainly located on the posterior and inferior, and LVA is on the anterior and apical segments. On cardiac MRI, pericardial LGE may suggest the presence of LVPA rather than LVA in suspected patients.

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A curious case of stent fracture and left ventricular pseudoaneurysm – A rare association in the background of cardiac tuberculosis

Cited by 2 publications

References 1 publication

Coronary Stent Fracture Causing Myocardial Infarction: Case Report and Review of Literature

Coronary Stent Fracture Causing Myocardial Infarction: Case Report and Review of Literature

Clinical characteristic and imaging findings of post-infarction left ventricular pseudoaneurysm versus aneurysm: a pooled analysis of 21,472 patients

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