Coronary Pseudoaneurysm and Stent Disruption Caused by Infective Endocarditis

Daisuke Kanda; Nobuhiro Ito; Mitsuru Ohishi

doi:10.1016/j.jaccas.2025.106337

Coronary Pseudoaneurysm and Stent Disruption Caused by Infective Endocarditis

JACC Case Rep. 2026 Feb 11;31(6):106337. doi: 10.1016/j.jaccas.2025.106337. Epub 2025 Dec 3.

Authors

Daisuke Kanda¹, Nobuhiro Ito², Mitsuru Ohishi²

Affiliations

¹ Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan. Electronic address: kanchan@m3.kufm.kagoshima-u.ac.jp.
² Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.

Abstract

Images: Intravascular imaging (optical coherence tomography and intravascular ultrasound) demonstrating coronary pseudoaneurysm and stent disruption.

Case summary: A 65-year-old man undergoing hemodialysis for diabetic nephropathy developed methicillin-resistant Staphylococcus aureus infective endocarditis complicated by coronary pseudoaneurysm and stent disruption, resulting in cardiac tamponade. Intravascular imaging confirmed the complete destruction of the arterial wall. Emergency covered stent implantation and pericardiocentesis stabilized the patient, followed by a multidisciplinary treatment approach, including prolonged antibiotics and surgical source control, leading to survival.

Take-home message: Timely imaging-guided diagnosis and a stepwise multidisciplinary strategy were lifesaving in this extremely rare and complex case.

Keywords: endocarditis; imaging; percutaneous coronary intervention.