Giant mycotic RCA aneurysm -A very rare complication of PCI

Shetty, Laxmi H; Ashalatha, B; Sreedhar, Kumsi; Manjunath, Cholenahally Nanjappa

doi:10.1016/j.ihjccr.2018.09.002

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…The occurrence of mycotic aneurysms following PCI without concurrent IE is exceptionally rare. The literature contains limited reports on this condition, with the predominant cases involving the use of sirolimus-eluting stents [ 13 ], thereby posing a significant diagnostic challenge, especially in patients with bacteremia of unknown origin, as observed in our case. Early recognition is vital due to the elevated mortality associated with this condition in the absence of surgical intervention, as antibiotic treatment proves ineffective under such circumstances.…”

Section: Discussionmentioning

confidence: 94%

An Unseen Challenge: Mycotic Pseudoaneurysm Emerges in the Wake of Everolimus-Eluting Stent Deployment

Farouji,

Aboarqoub,

Battah

et al. 2024

Cureus

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This case report presents a unique instance of mycotic pseudoaneurysm in the proximal right coronary artery (RCA) following percutaneous coronary intervention (PCI) in a 75-year-old male with a complex medical history. Despite successful initial intervention and resolution of bacteremia, the patient presented three months later with recurrent anginal symptoms. The diagnostic evaluation revealed a mycotic pseudoaneurysm in the RCA, leading to surgical clipping and graft implantation. The successful surgical outcome underscores the critical role of early recognition and intervention in enhancing patient survival. This case contributes valuable insights into the diagnostic intricacies and therapeutic nuances of mycotic pseudoaneurysm, reinforcing the importance of maintaining a heightened index of suspicion, particularly in patients with a history of coronary interventions.

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Section: Discussionmentioning

confidence: 94%

An Unseen Challenge: Mycotic Pseudoaneurysm Emerges in the Wake of Everolimus-Eluting Stent Deployment

Farouji,

Aboarqoub,

Battah

et al. 2024

Cureus

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“…Infected CAAs are very rare in their occurrence and various hypotheses have been proposed for the pathogenesis of mycotic aneurysms such as micro embolization to the vasa vasorum, pathogen invasion of the arterial wall, or immune complex deposition, resulting in medial injury and destruction [ 9 , 10 ]. It has also been hypothesized that DES might increase the susceptibility to infection because of the antiproliferative and immunosuppressive effects of the drug hampering the local host defense mechanism as well as delays the process of endothelization [ 5 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The most common organism associated with coronary artery stent infection is Staphylococcus aureus (80%) followed by Pseudomonas aeruginosa (20%) and our patient had grown pseudomonas aeruginosa from the tissue culture [ 8 , 19 ]. Infected CAAs carry significant morbidity and mortality and complications include thrombosis, distal embolization, rapid expansion, and rupture [ 9 , 10 ]. Our patient was unique as he had a rapid progression in size from a small to a giant aneurysm within one month of the coronary intervention and remained afebrile throughout the hospitalization despite having Pseudomonas aeruginosa infection.…”

Section: Discussionmentioning

confidence: 99%

Unusual Presentation of a Rapidly Progressive Coronary Artery Pseudoaneurysm after Drug Eluting Stent Placement

Reddy¹,

K²,

Mahant³

et al. 2021

Cureus

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Infected coronary artery aneurysm (CAA) is a rare complication of percutaneous coronary intervention (PCI) and is associated with high morbidity and mortality. The management of infected CAA is unclear and is based on the clinical and imaging features. We report an interesting case of a giant infected right CAA secondary to Pseudomonas aeruginosa within four weeks of a drug eluting stent (DES) implantation. Chronological analysis of the coronary angiograms and computed tomography coronary angiography revealed rapid progression in the size of the aneurysm from small to a giant CAA over a period of four weeks. Patient remained afebrile throughout the hospital stay without any signs of septicaemia. In view of the rapid progression in size, surgical aneurysmal ligation with distal revascularisation was done with good post-operative recovery. Afebrile presentation of an infected CAA is very rarely reported in the literature as in our case. Early diagnosis using multimodality imaging and immediate surgical intervention are the cornerstone in the management of giant infected CAAs.

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Upper gastrointestinal obstruction as an unusual presentation of thoracoabdominal huge aortic aneurysm; a case report

Jahanshahi,

Zeraatian Nejad Davani,

Naderi

2024

International Journal of Surgery Case Reports

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Giant mycotic RCA aneurysm -A very rare complication of PCI

Cited by 3 publications

References 12 publications

An Unseen Challenge: Mycotic Pseudoaneurysm Emerges in the Wake of Everolimus-Eluting Stent Deployment

An Unseen Challenge: Mycotic Pseudoaneurysm Emerges in the Wake of Everolimus-Eluting Stent Deployment

Unusual Presentation of a Rapidly Progressive Coronary Artery Pseudoaneurysm after Drug Eluting Stent Placement

Upper gastrointestinal obstruction as an unusual presentation of thoracoabdominal huge aortic aneurysm; a case report

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