Pseudomonas aeruginosa Coronary Stent Infection

Bouchart, F; Dubar, Arnaud; Bessou, Jean Paul; Redonnet, M; Berland, Jacques; Mouton-Schleifer, D; Haas-Hubscher, Catherine; Soyer, R

doi:10.1016/s0003-4975(97)01151-x

Cited by 47 publications

(21 citation statements)

References 7 publications

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“…[147][148][149][150][151] The incubation period ranged between 4 days and 4 weeks, and the responsible organism was either S aureus (nϭ3) or P aeruginosa (nϭ2). 146 Associated findings consisted of local abscess formation, suppurative pancarditis, and pericardial empyema.…”

Section: Coronary Artery Stentsmentioning

confidence: 99%

Nonvalvular Cardiovascular Device–Related Infections

Baddour¹,

Bettmann²,

Bolger³

et al. 2003

Circulation

443

326

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Section: Coronary Artery Stentsmentioning

confidence: 99%

Nonvalvular Cardiovascular Device–Related Infections

Baddour¹,

Bettmann²,

Bolger³

et al. 2003

Circulation

443

326

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“…The most common pathogen of purulent pericarditis associated with PCI is Staphylococcus aureus, but Pseudomonas aeruginosa can also cause stent infection. 9,10 In the present case, neither of these pathogens appeared to cause pleuropericarditis, because prophylactic cefazolin sodium could have possibly prevented staphylococcal infection. Corticosteroids, rather than piperacillin sodium, was effective for the improvement of symptom and laboratory data of inflammation.…”

Section: Discussionmentioning

confidence: 49%

“…The causes include PCIS and a stent bacterial infection because of Staphylococcus aureus or Pseudomonas aeruginosa. [3][4][5][8][9][10] The diagnosis of PCIS depends on the characteristic clinical features. The principal features of PCIS are prior injury of the pericardium and/or myocardium, latent period between the injury and the development of pericarditis or pleuropericarditis, fever, leukocytosis, elevated ESR and serum CRP level, and remarkable steroid responsiveness.…”

Section: Discussionmentioning

confidence: 99%

Acute Pleuropericarditis After Coronary Stenting A Case Report

Setoyama

Furukawa

Abe

et al. 2006

Circ J

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leuropericarditis has a variety of causes, which include viral or bacterial infections, autoimmunity, malignant neoplasm, and other cardiac insults, such as myocardial infarction and surgery or trauma to the heart. The syndrome of pleuropericarditis with fever, pleuritic chest pain, and elevated inflammatory markers secondary to cardiac injury is referred to as post-cardiac injury syndrome (PCIS). PCIS is an inflammatory process involving the pleura and pericardium and includes 2 distinct entities: post-myocardial infarction syndrome secondary to myocardial infarction and post-cardiotomy syndrome secondary to cardiac surgery or trauma. 1 PCIS after open-heart surgery is rather common and the incidence is reported as 10-50%. 2 Recently, a few reports have described PCIS occurring as a rare complication after endovascular procedures such as percutaneous coronary intervention (PCI) and trans-venous temporary/permanent pacing. [3][4][5][6][7] We present a case of acute pleuropericarditis which occurred after successful coronary stenting with atypically early onset for PCIS. Case ReportA 72-year-old male hypertensive patient was admitted to hospital because of stable effort angina pectoris which appeared 2 months before admission. Treadmill stress test reproduced his chest symptoms, accompanied with reversible significant ST-segment depression in an electrocardiogram (ECG). Echocardiogram showed concentric left ventricular hypertrophy and mild left ventricular asynergy in the inferior wall. Coronary angiography revealed total occlusion in the middle right coronary artery (RCA) and 75% stenosis in the proximal RCA (Fig 1), and the distal RCA was filled through collateral circulation from the left coronary artery. The patient subsequently underwent PCI for the RCA. A 0.014 inch Miracle 3 g guidewire (Getz Bros) and a 0.014 inch PT Graphix guidewire (Boston Scientific) were used to cross the total occlusion lesion, with the aid of a microcatheter (Excelsior; Boston Scientific). The guidewire was replaced by a more flexible 0.014 inch BMW guidewire (Guidant Corporation) through the Excelsior. The lesion was predilated using a 2.0×15 mm Victo-X balloon catheter (Nippon Sherwood). Because the intravascular ultrasound examination indicated a large volume of plaque causing moderate stenoses in almost the full length of the proximal to middle RCA, 3 Cypher stents (2.5× 28 mm, 3.0×33 mm, 3.5×23 mm; Johnson & Johnson) were used from the distal to the ostium of the RCA. Adjunctive postdilatation was performed with 3.0 mm and 3.5 mm stent balloons. Thus, the 75% stenotic and total occlusion lesions were successfully dilated to 0%. There were not any immediate clinical or angiographic signs of complications throughout the procedure.Four hours after PCI, the patient complained of a mild chest pain which was augmented by deep breathing. However, his blood pressure, pulse pressure, and arterial oxygen saturation were maintained stable and ECG indicated no significant changes from his reference ECG before PCI. Thus, he was given non-s...

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“…The final reported subtype in the published literature is mycotic or infectious in etiology (type III) 40,41,42 . Large mycotic aneurysms infected with Staphylococcus aureus after DES or BMS implantation have been reported.…”

Section: Discussionmentioning

confidence: 99%

Drug-Eluting Stent (DES) Induced Coronary Artery Aneurysm - A Rare Case Report

et al. 2017

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Introduction:Coronary artery aneurysms after coronary intervention are rare, the incidence of coronary artery aneurysms after DES implantation is low within the first 9 months, with a reported incidence of 0.2% to 2.3%, a rate similar to that reported after bare-metal stent (BMS) implantation (0.3% to 3.9%) in the DES versus BMS randomized trials. Most "aneurysms" are in fact pseudoaneurysms rather than true aneurysms [1][2][3][4] . Residual dissection and deep arterial wall injury (rupture or resection of the vessel media) caused by oversized balloons or stents, high pressure balloon inflations, atherectomy, and laser angioplasty have all been associated with coronary artery aneurysms after coronary intervention 1-3 . Drug-eluting stents (DES), which locally elute antiproliferative drugs, can dramatically inhibit neointimal growth, thereby suppressing restenosis 5,6 , but at the same time potentially causing coronary aneurysms due to other mechanisms, such as delayed reendothelialization, inflammatory changes of the medial wall, and hypersensitivity reactions [7][8][9][10] . These findings may be due to delayed healing secondary to the antiproliferative action of the eluted drug, cell necrosis and/or apoptosis from the antimetabolite effect of the drug, and hypersensitivity reactions to the drug/polymer mixture on the DES 7-9 . Systemic administration of antiinflammatory agents (glucocorticoids and colchicine) after stent implantation may be associated with a greater risk of aneurysm formation. 11 However, the true incidence, clinical course, and treatment of coronary artery aneurysms after DES implantation remain largely unknown.Case Report: Mr. X, 60 years old non smoker, non alcoholic, diabetic, hypertensive businessman got admitted in NICVD with complaint of ischaemic chest pain on minimal exertion for 3 months. ECG was within in normal limit, ETT was positive and Echocardiogram showed Anterior wall hypokinesia with EF-65%. CAG showed Significant long lesion in LAD. Direct stenting to LAD was done at the same setting with Promus Element ( 2.75×38mm, at 18 ATM).Whole procedure was uneventful and patient was discharged from hospital with double antiplatelet coverage. After 10 days of PCI patient got readmitted in hospital with complaints of chest discomfort with high grade fever for 2 days. ECG showed AMI ( Extensive Anterior) indicating involvement of LAD territory with strong suspicion of Sub Acute Stent Thrombosis (SAST). Streptokinase could not be given due to delayed arrival. Patient was treated conservatively with LMWH. Blood and urine culture was negative. Check CAG was done 7 days after readmission showing Patent stent in LAD with aneurysmal dilatation at the distal end of stent in LAD. Drug-Eluting Stent (DES) Induced Coronary

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Pseudomonas aeruginosa Coronary Stent Infection

Cited by 47 publications

References 7 publications

Nonvalvular Cardiovascular Device–Related Infections

Nonvalvular Cardiovascular Device–Related Infections

Acute Pleuropericarditis After Coronary Stenting A Case Report

Drug-Eluting Stent (DES) Induced Coronary Artery Aneurysm - A Rare Case Report

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