Late Silent Stent Abscess

Dmitry Zateyshchikov, Elvira Fattakhova, Vladimir Demchinsky, Tatiana Baklanova, Victor Serebruany

Research output: Contribution to journalArticle

Abstract

Background: Coronary stent infections in general and stent abscesses (SAs) in particular are rare but often deadly complications. Most SAs manifest with fever and chest pain within 30 days after intervention and require antibiotics and stent removal. Case Report: A 45-year-old man with second ST elevated myocardial infarction and cardiogenic shock was admitted to a hospital that had no cardiac catheterization laboratory. The patient underwent fibrinolytic therapy with alteplase but died 1 h later. His medical history revealed posterior myocardial infarction 7 years before, which had been successfully treated with a bare metal stent of the right coronary artery. The post-discharge observation had been unremarkable with no evidence of ischaemia or infection but gross non-compliance. Autopsy revealed complete closure of the left main coronary artery and a surprise additional finding, namely SA; the stented portion of the artery was enveloped by an abscess, and purulent material completely occluded the stent, which was floating in pus. Impressions: Since coronary angioplasty is so common, the incidence of late silent SA is probably higher than expected, especially considering that there is often a lack of clinical manifestations. Clinicians should be cognizant of this complication. More attention may be required to assess the condition of existing stents during repeated interventions. Gross non-compliance and/or early withdrawal from dual anti-platelet therapy may be directly responsible for the development of silent delayed SA.

Original languageEnglish (US)
Pages (from-to)65-67
Number of pages3
JournalCardiology
Volume132
DOIs
StatePublished - Aug 25 2015

Keywords

  • Abscess
  • Autopsy
  • Complication
  • Coronary stent
  • Infections

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

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  • Cite this

    Zateyshchikov, D., Fattakhova, E., Demchinsky, V., Baklanova, T., & Serebruany, V. (2015). Late Silent Stent Abscess. Cardiology, 132, 65-67. https://doi.org/10.1159/000398789