An Unusual Complication of Infective Endocarditis Treated by Percutaneous Intervention

Area of Science:

• Cardiology
• Vascular Surgery
• Infectious Diseases

Background:

• Mycotic pseudoaneurysms (PA) are uncommon but serious complications of infective endocarditis (IE).
• While advanced imaging and early treatment have reduced incidence, PAs remain a critical concern.
• Intracranial vessels are the most frequent site, followed by abdominal and peripheral vasculature.

Observation:

• A young patient with a bicuspid aortic valve developed infective endocarditis.
• This led to the formation of a giant mycotic pseudoaneurysm.
• Initial treatment involved a cover stent, which subsequently migrated distally.

Findings:

• The mycotic pseudoaneurysm presented a significant management challenge.
• Distal stent migration complicated the initial endovascular approach.
• Surgical intervention in the form of bypass surgery was ultimately required for successful management.

Implications:

• This case underscores the potential for complex presentations of mycotic pseudoaneurysms.
• It highlights the limitations of endovascular techniques in certain PA cases.
• Successful management may necessitate a multidisciplinary approach involving vascular surgery.