Your new experience awaits. Try the new design now and help us make it even better

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
Can  LiCan LiChun-Chang  QinChun-Chang Qin*Yue  JiangYue JiangLin  HouLin Hou
  • Department of Cardiovascular Medicine, First Affiliated Hospital of Chongqing Medical University, Chongqing, China

The final, formatted version of the article will be published soon.

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

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.