Advertisement

Implantation of multiple polytetrafluoroethylene covered stent inside drug eluting stent to rescue purulent coronary artery ectasia with giant saccular aneurysm

  • Yusuke Namba
  • Toshiaki Yamanaka
  • Jun Ida
  • Takefumi Oka
Case in Point

Abstract

A 79-year-old male with diabetes mellitus and old cerebral infarction was admitted to hospital due to fever and palpitation. Diagnosis of purulent pericarditis was established by pericardial effusion examination. The patient’s general condition improved temporarily after drainage of the pericardial effusion. However, computed tomography demonstrated a saccular aneurysm arising from RCA have rapidly grown even larger, up to 63 × 51 mm on 7th hospital day. This indicated that the risk of rupture of the aneurysm was high. Percutaneous coronary intervention was applied to prevent rupture of the aneurysm. Several polytetrafluoroethylene (PTFE)-covered stents were required to cover the extended aneurysm lesion. A long drug-eluting stent (DES), which was initially implanted through the aneurysm, was itself implanted with 3 PTFE-covered stents located inside the DES. This procedure provided protection against endoleak of the aneurysm. To our knowledge, the present case shows for the first time that PTFE-covered stents located within DES are useful in treatment of a giant coronary aneurysm.

Keyword

PCI for giant coronary aneurysm Purulent pericarditis Computed tomography Polytetrafluoroethlene covered stents 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

Supplementary material

10554_2018_1312_MOESM1_ESM.avi (3.8 mb)
Supplementary material 1 Movie A: coronary angiography (CAG) before percutaneous coronary intervention (AVI 3879 KB)
10554_2018_1312_MOESM2_ESM.avi (4.1 mb)
Supplementary material 2 Movie B: CAG of endoleak after implantation of PTFE- covered coronary stents (lengths 16 and 19 mm) (AVI 4174 KB)
10554_2018_1312_MOESM3_ESM.avi (3.6 mb)
Supplementary material 3 Movie C: Final CAG (AVI 3659 KB)

References

  1. 1.
    Diaz-Zamudio M, Bacilio-Perez U, Herrera-Zarza MC, Meave-Gonzalez A, Alexanderson-Rosas E, Zambrana-Balta GF, Kimura-Hayama ET (2009) Coronary artery aneurysms and ectasia: role of coronary ct angiography. Radiographics 29:1939–1954CrossRefPubMedGoogle Scholar
  2. 2.
    Sagrista-Sauleda J, Barrabes JA, Permanyer-Miralda G, Soler-Soler J (1993) Purulent pericarditis: review of a 20-year experience in a general hospital. J Am Coll Cardiol 22:1661–1665CrossRefPubMedGoogle Scholar
  3. 3.
    Nichols L, Lagana S, Parwani A (2008) Coronary artery aneurysm: a review and hypothesis regarding etiology. Arch Pathol Lab Med 132:823–828PubMedGoogle Scholar
  4. 4.
    Salinas G, Kumar D, Lick S, Vijayakumar V, Rahman M, Uretsky BF (2007) Infective coronary aneurysm: a complication of percutaneous coronary intervention. Tex Heart Inst J 34:91–94PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of CardiologyTsuyama Chuo HospitalTsuyamaJapan

Personalised recommendations