A rare complication that reminds us why persistent fever and chest pain after PCI should never be ignored Percutaneous coronary intervention (PCI) has transformed the management of coronary artery disease. For most patients, coronary stenting is a routine and highly effective intervention. But occasionally, a complication emerges that challenges even experienced clinicians—and demands a much higher index of suspicion. Imagine a patient returning shortly after PCI with persistent fever and chest pain. The initial ECG may not show dramatic changes.

Echocardiography may reveal preserved ventricular function. Yet beneath the apparently reassuring findings, a devastating process may be developing around the coronary stent. This is the story of the “ Vanishing Stent Phenomenon” —a rare manifestation of coronary stent infection associated with a mycotic coronary pseudoaneurysm. The Case: Fever…