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

Sreenivas Reddy1, Raghavendra Rao K1, Tek Singh Mahant2

  • 1Department of Cardiology, Government Medical College and Hospital, Chandigarh, IND.

Cureus
|March 19, 2021
PubMed

Insights

Infected coronary artery aneurysms (CAAs) are rare but serious complications after stenting. This case highlights a rapidly growing, afebrile infected CAA managed successfully with surgery.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Vascular Surgery

Background:

  • Infected coronary artery aneurysm (CAA) is a rare complication post-percutaneous coronary intervention (PCI).
  • Management strategies for infected CAA remain unclear, relying on clinical and imaging findings.
  • High morbidity and mortality rates are associated with infected CAA.

Observation:

  • A case of a giant infected right CAA caused by Pseudomonas aeruginosa is presented.
  • The aneurysm developed rapidly within four weeks of drug-eluting stent (DES) implantation.
  • The patient remained afebrile and without signs of septicaemia throughout hospitalization.

Findings:

  • Coronary angiograms and CT coronary angiography showed rapid aneurysm growth from small to giant size in four weeks.
  • Surgical aneurysmal ligation with distal revascularization was performed due to rapid progression.
  • The patient experienced good post-operative recovery.

Implications:

  • Afebrile presentation of infected CAA is uncommon and poses diagnostic challenges.
  • Multimodality imaging is crucial for early diagnosis of infected CAA.
  • Prompt surgical intervention is essential for managing giant infected CAAs.

Keywords:
coronary artery aneurysmdrug eluting stentpercutaneous coronary intervention

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