Coronary stent infection — A grave, avoidable complication

Coronary stent infection (CSI) is the rarest complication associated with the percutaneous coronary intervention, occurring in less than 0.1% of cases. So far, all reported instances are limited to case reports. CSI presents itself in various, often confusing, ways in clinical settings. Therefore, the current systematic review summarizes reports of CSI's clinical presentations, causative pathogens, diagnoses and treatments. This systematic review considered three online databases, using reference lists as an additional source. All case reports or case series with stent infection in the coronary artery were included -however, reviews or commentaries, articles not published in English, and articles mentioning a history of hemodialysis or any surgery were excluded. Thirtytwo studies on 34 CSI patients were included in the final qualitative analysis. CSI predominantly affected males of a wide range of ages. The most common symptoms were chest pain and fever with various onsets. Interestingly, CSI usually occurred during the first stent implantation. Cultures and coronary angiography were the most common methods used to diagnose CSI. Furthermore, drug-eluting stents had a higher risk of infection than bare-metal stents. Aneurysms were the most frequent abnormalities observed in infected stents. The bacteria that most often caused CSI were Staphylococcus aureus and Pseudomonas aeroginosa. More than 90% of the reports mentioned using various antibiotics, and 74% mentioned carrying out surgery. Finally, a mortality rate of 26.47% among CSI patients was calculated.

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“…[26] and Dalal et al . [29] reported cardiogenic shock and cardiac arrest, respectively, upon the admission of the CSI case.…”

Section: Resultsmentioning

confidence: 99%

“…Most cases reported fever (76.47%) and chest pain (52.94%) as primary symptoms, followed by shortness of breath (11.76%). Additionally, Zateyshchikov et al [26] and Dalal et al [29] reported cardiogenic shock and cardiac arrest, respectively, upon the admission of the CSI case.…”

Section: Clinical Presentationsmentioning

confidence: 95%

Coronary stent infection: a systematic review

Suryawan

Luke

Agustianto

et al. 2021

Coronary Artery Disease

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“…Treatment with conventional antibiotics against bacterial biofilms formed on implants is inefficient to eradicate the infecting microorganism due to its low bacterial metabolic activity and biofilm protective matrix [3], resulting in a chronic infection of difficult treatment that requires the implant to be removed. Cases of vascular stent infections are rare complications, but associated with high mortality rates; according to current data, mortality may reach 40%, despite antibiotic treatment and/or surgical removal [4,5]. The most likely cause of stent infections is equipment reuse, such as balloons, catheters, and guide-wire, or poor ascetical techniques during the procedure [6].…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial and Antibiofilm Effects of Peptides from Venom of Social Wasp and Scorpion on Multidrug-Resistant Acinetobacter baumannii

Neves

Mortari

Schwartz

et al. 2019

Toxins

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Intravascular stent infection is a rare complication with a high morbidity and high mortality; bacteria from the hospital environment form biofilms and are often multidrug-resistant (MDR). Antimicrobial peptides (AMPs) have been considered as alternatives to bacterial infection treatment. We analyzed the formation of the bacterial biofilm on the vascular stents and also tested the inhibition of this biofilm by AMPs to be used as treatment or coating. Antimicrobial activity and antibiofilm were tested with wasp (Agelaia-MPI, Polybia-MPII, Polydim-I) and scorpion (Con10 and NDBP5.8) AMPs against Acinetobacter baumannii clinical strains. A. baumannii formed a biofilm on the vascular stent. Agelaia-MPI and Polybia-MPII inhibited biofilm formation with bacterial cell wall degradation. Coating biofilms with polyethylene glycol (PEG 400) and Agelaia-MPI reduced 90% of A. baumannii adhesion on stents. The wasp AMPs Agelaia-MPI and Polybia-MPII had better action against MDR A. baumannii adherence and biofilm formation on vascular stents, preventing its formation and treating mature biofilm when compared to the other tested peptides.

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Gentamicin

2017

Reactions Weekly

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Coronary stent infection — A grave, avoidable complication

Cited by 4 publications

References 4 publications

Coronary stent infection: a systematic review

Coronary stent infection: a systematic review

Antimicrobial and Antibiofilm Effects of Peptides from Venom of Social Wasp and Scorpion on Multidrug-Resistant Acinetobacter baumannii

Gentamicin

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