Key result
Post-PCI weight loss and recurrent fevers raise high suspicion for rare infected coronary artery aneurysms.
Why the study?
Coronary artery aneurysms are uncommon complications of PCI, and infected aneurysms are even rarer, with limited guidance on management.
Case Report (n=1)
Infected coronary artery aneurysm is a rare complication of PCI that requires a high index of suspicion in patients presenting with weight loss and recurrent fevers post-procedure.
May prompt consideration of infected aneurysms in select post-PCI cases; leaves open questions on incidence and management.
BACKGROUND: Coronary artery aneurysms are uncommon complications of percutaneous coronary intervention (PCI), and infected aneurysms are rarer still. CASE SUMMARY: A 41-year-old man presented with significant weight loss, recurrent chest pain, and fever spikes lasting for 3 months. Three weeks before symptom onset, he had undergone PCI with a drug-eluting stent placed in the right coronary artery (RCA). Two-dimensional echocardiography and cardiac magnetic resonance imaging revealed a mass anterior to the heart with stent in situ. After taking antibiotics for 6 weeks, the patient underwent excision of the mass containing the stent, thrombus, and inflammatory tissue. As the distal segment of the RCA was thrombosed, ligation or bypass grafting was not possible. Postoperatively, the patient improved dramatically. DISCUSSION: Coronary artery aneurysms are rare complications of PCI, more prevalent after biodegradable stents than drug-eluting stents. While life-threatening complications do exist, the decision of medical versus surgical management rests in the hands of multidisciplinary team members and must be made on a case-by-case basis. TAKE-HOME-MESSAGE: It is important to approach weight loss and recurrent fevers after PCI with a high index of suspicion.
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Harikrishnan et al. (2026) conducted a case report in Infected Coronary Artery Aneurysm (n=1). Antibiotics and surgical excision was evaluated on Clinical improvement. Surgical excision following a 6-week course of antibiotics resulted in dramatic clinical improvement in a 41-year-old man with an infected coronary artery aneurysm complicating recent PCI.
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