在经皮冠状动脉干预后,急性冠状动脉支架感染与伪动脉瘤形成和支架分离
Malin Renee Flygel1, Nigusssie Bogale1, Steinar Lundemoen1
1Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
JACC. Case reports
|July 4, 2025
概括
在冠状动脉干预后,一种罕见的急性支架感染病例导致了黄金杆菌菌菌病. 成功的开放心脏手术移除了受感染的支架和伪动脉瘤,患者康复良好.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 干预心脏病学 干预心脏病学
背景情况:
- 冠状动脉干预,包括慢性全闭性冠状动脉干预 (PCI) 是常见的程序.
- 虽然通常是安全的,但可能会出现并发症,需要仔细监测患者.
研究的目的:
- 为CTO报告PCI后急性支架感染的病例.
- 讨论这种罕见并发症的诊断挑战和管理.
主要方法:
- 一位先前接受过多次冠状动脉干预的患者接受了PCI,在右冠状动脉中植入支架.
- 观察了手术后的发烧和金黄色葡萄球菌菌病.
- 诊断成像包括正子发射断层扫描-计算机断层扫描 (PET-CT) 和后续CT扫描.
主要成果:
- PET-CT显示了支架附近的氧葡萄糖吸收,这表明感染.
- 随访CT显示伪动脉瘤形成和怀疑支架分离.
- 手术干预成功移除了伪动脉瘤和支架,患者康复良好.
结论:
- 对冠状动脉干预后的败血症症状进行密切监测至关重要.
- 多学科的讨论和迅速的行动对于管理罕见的并发症至关重要,如真菌冠状动脉瘤.
相关概念视频
Aneurysm III: Interprofessional Care
29
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
29
Aneurysm I: Introduction
30
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
30
Acute Coronary Syndrome I: Introduction
80
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
80
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
49
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
49
Acute Coronary Syndrome IV: Interprofessional Care
32
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
32
Coronary Artery Disease V: Interprofessional Care
38
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
38


