{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:08:41Z","timestamp":1788480521942,"version":"build-2803163510"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Purulent pericarditis is an infectious condition characterized by purulent pericardial effusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>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\u2005mg alteplase. During follow-up, the patient achieved complete clinical recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1660781","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T05:25:03Z","timestamp":1754371503000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Eccentric purulent pericarditis treated by PTCA guidewire-based pericardiocentesis and intrapericardial alteplase"],"prefix":"10.3389","volume":"12","author":[{"given":"Can","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Chang","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"845","DOI":"10.12669\/pjms.304.3743","article-title":"Diagnostic value of the biochemical tests in patients with purulent pericarditis","volume":"30","author":"Ekim","year":"2014","journal-title":"Pak J Med Sci"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.1016\/j.rec.2015.10.008","article-title":"2015 ESC guidelines for the diagnosis and management of pericardial diseases","volume":"68","author":"Adler","year":"2015","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"17","DOI":"10.31083\/j.rcm2401017","article-title":"Fibrinolytic therapy in purulent pericarditis","volume":"24","author":"Dybowska","year":"2023","journal-title":"Rev Cardiovasc Med"},{"key":"B4","first-page":"5","article-title":"Prevention of pericardial constriction by transcatheter intrapericardial fibrinolysis with urokinase","volume":"20","author":"Cui","year":"2005","journal-title":"Chin Med Sci J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1080\/08998280.2021.1889297","article-title":"Acute purulent pericarditis treated conservatively with intrapericardial fibrinolysis and intrapericardial and systemic antibiotics","volume":"34","author":"Abdelnabi","year":"2021","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s12245-015-0087-y","article-title":"Intrapericardial fibrinolysis in purulent pericarditis: case report","volume":"8","author":"Dybowska","year":"2015","journal-title":"Int J Emerg Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1186\/s12872-020-01674-z","article-title":"Intrapericardial recombinant tissue plasminogen activator in purulent pericarditis- case series","volume":"20","author":"Dybowska","year":"2020","journal-title":"BMC Cardiovasc Disord"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e35172","DOI":"10.7759\/cureus.35172","article-title":"Intrapericardial fibrinolytic therapy in purulent pericarditis: a review of two cases","volume":"15","author":"Poudyal","year":"2023","journal-title":"Cureus"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e015412","DOI":"10.1161\/circimaging.123.015412","article-title":"Treatment of purulent pericarditis with intrapericardial alteplase","volume":"16","author":"Zhang","year":"2023","journal-title":"Circ Cardiovasc Imaging"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1660781\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T05:25:05Z","timestamp":1754371505000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2025.1660781\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,5]]},"references-count":9,"alternative-id":["10.3389\/fcvm.2025.1660781"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2025.1660781","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,5]]},"article-number":"1660781"}}