Fractured Coronary Stent with Mycotic Pseudoaneurysm and Abscess

Clinical Image

Fractured Coronary Stent with Mycotic Pseudoaneurysm and Abscess

  • Naveen Kumar *
  • Surendar A
  • Sapna S Marda

Department of Radiodiagnosis, Yashoda hospital, Secunderabad, Telangana, India.

*Corresponding Author: Naveen Kumar, Department of Radiodiagnosis, Yashoda Hospital, Secunderabad, Telangana, India.

Citation: N Kumar, A Surendar, Sapna S Marda. (2023). Fractured Coronary Stent with Mycotic Pseudoaneurysm and Abscess. Journal of Clinical Cardiology and Cardiology Research, BRS Publishers. 2(1); DOI: 10.59657/2837-4673.brs.23.005

Copyright: © 2023 Naveen Kumar, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: November 18, 2022 | Accepted: February 09, 2023 | Published: February 15, 2023

Abstract


Keywords:

Introduction

A 66-year-old male with a known history of percutaneous transluminal coronary angioplasty with stenting of right coronary artery, presented with fever and abdominal pain. A chest X-Ray (Panel A) showed a radio opacity in right lower zone (red arrow) with a broad base towards mediastinum and obscured right hemidiaphragm (blue arrow). An ultrasound abdomen (Panel B) showed an irregular heterogenous collection (blue arrow) with thick internal septations in right sub diaphragmatic region. Volume rendering technique images (Panel C & D) showed a fractured stent in the right coronary artery (yellow arrow) and a focal contrast filled pseudoaneurysm arising from the aortic root (white arrow). Contrast CT showed a multi lobulated collection in the mediastinum extending from the ascending aorta, along the right border of the heart across the right dome of diaphragm (Panel E, white arrow) into the right sub phrenic space and compressing the right chambers of heart and liver (Panel F, green arrow). Methicillin-resistant staphylococcus aureus grown on blood culture. The patient started receiving intravenous vancomycin and referred to cardio-thoracic surgery for further management. Fractured coronary stent with mycotic pseudoaneurysm, mediastinal and sub diaphragmatic abscess is a rare life-threatening complication following percutaneous coronary angioplasty. The diagnosis of this condition remains difficult and requires imaging. It must be considered whenever a patient develops fever and chest pain after stent implantation. Aseptic precautions will prevent these complications.

Acknowledgement

None.

Conflicts Of Interest 

No Conflicts of Interest.

References