CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1660781
This article is part of the Research TopicCardiovascular Imaging Case Reports 2025: Emphasizing Uncommon Clinical ScenariosView all 6 articles
Case Report: Eccentric Purulent Pericarditis Treated by PTCA Guidewire-Based Pericardiocentesis and Intrapericardial Alteplase
Provisionally accepted
- Department of Cardiovascular Medicine, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Background: Purulent pericarditis is an infectious condition characterized by purulent pericardial effusion.In this case report, we present a 60-year-old male admitted with intermittent chest pain and fever, ultimately diagnosed with primary purulent pericarditis. Imaging revealed an eccentric loculated pericardial effusion, posing significant challenges for conventional pericardiocentesis. In this context, we innovatively employed a percutaneous transluminal coronary angioplasty (PTCA) guidewire-based pericardiocentesis technique, achieving successful catheter placement followed by intrapericardial administration of 5 mg alteplase. During follow-up, the patient achieved complete clinical recovery.This report introduces a PTCA guidewire-based pericardiocentesis approach, which safely addresses complex eccentric loculated pericardial effusions. Combined with low-dose intrapericardial alteplase, drainage efficacy was enhanced, pericardial adhesions were reduced, and invasive pericardiectomy could be avoided. This minimally invasive technique provides a viable alternative to surgery for high-risk patients.
Keywords: PTCA guidewire-based pericardiocentesis, eccentric purulent pericarditis, Fibrinolysis, Pericardial Effusion, cross-disciplinary application of medical devices
Received: 06 Jul 2025; Accepted: 17 Jul 2025.
Copyright: © 2025 Li, Qin, Jiang and Hou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chun-Chang Qin, Department of Cardiovascular Medicine, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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