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25-04-2024 | Acute Kidney Injury | Case report

Coronary stent infection and acute stent occlusion with peri-stent abscess: a case report

Authors: Venkata Rajasekhara Rao Ketana, Ayindrila Mukherjee, Sabiha Nigar Syeda

Published in: Indian Journal of Thoracic and Cardiovascular Surgery

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Abstract

Coronary stent infection is considered the rarest complication of percutaneous coronary intervention, occurring in less than 0.1% of the cases. In this article, a case of coronary stent infection and acute stent occlusion with surrounding peri-stent coronary abscess has been reported. A 46-year-old male presented to the emergency at our centre on 11/07/2022 with chief complaints of intermittent fever spikes and intermittent chest pain since the past 1 week. He had been diagnosed with acute inferior and posterior wall myocardial infarction on 20/06/2022 and had undergone percutaneous coronary intervention (PCI) with drug eluting stent (DES) implantation to the right coronary artery (RCA) following thrombolysis with tenecteplase at a different center. He was non-diabetic and non-hypertensive and on dual antiplatelet therapy post PCI. On presentation, he was anxious but alert and cooperative. He underwent check coronary angiogram on 30/06/2022 followed by a computerized tomography (CT) coronary angiogram on 12/07/2022. He was finally diagnosed with acute stent occlusion and peri-stent abscess in RCA. Preoperatively, he had raised liver transaminases, mild neutrophilic leukocytosis with normal renal function test values, and a negative blood culture report. He was operated on 14/07/2022. Surgical procedure included infected stent retrieval from RCA and peri-stent abscess drainage. Stent and pus culture sensitivity was negative for causative microorganisms. Post surgery, he had continued fever spikes and antibiotics were escalated. He also developed non-oliguric acute kidney injury (AKI) and pericarditis. He was treated medically for the post-op complications and was discharged on optimal medical management. On follow-up visits, his renal function tests showed improvement and there was no recurrence of fever or chest pain in 1-year follow-up.
Literature
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Metadata
Title
Coronary stent infection and acute stent occlusion with peri-stent abscess: a case report
Authors
Venkata Rajasekhara Rao Ketana
Ayindrila Mukherjee
Sabiha Nigar Syeda
Publication date
25-04-2024
Publisher
Springer Nature Singapore
Published in
Indian Journal of Thoracic and Cardiovascular Surgery
Print ISSN: 0970-9134
Electronic ISSN: 0973-7723
DOI
https://doi.org/10.1007/s12055-024-01732-7
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