Stroke as a complication of cardiac catheterization: Risk factors and clinical features

Abstract

The authors aimed to delineate the risk factors and radiologic pattern of stroke complicating cardiac catheterization. Twenty-two cases were matched with three control subjects. Stroke was significantly associated with severity of coronary artery disease and length of fluoroscopy time (OR 1.96 and 1.65). The use of MRI with diffusion weighting allowed the identification of multiple asymptomatic lesions and a subset of lacunar-type infarcts (23%), which most likely occurred on an atheroembolic basis.

Stroke Complicating Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

“…Despite of the improvement in techniques and devices, the rate of stroke has increased over the decades. [1][2][3][4][5][6][7][8] In the late 1970 s to early 1980 s, the incidence of stroke was in the range of 0.03 to 0.06%. 1,2 From the early 1990 s to recent years, the rate has been 0.12 to 0.3%.…”

“…1,2 From the early 1990 s to recent years, the rate has been 0.12 to 0.3%. [3][4][5][6][7][8] A possible explanation for the increased incidence is using PCI for higher-risk patients. The incidence of stroke in the present study was higher than previous reports, which is probably because of different patient characteristics.…”

Silent cerebral emboli following percutaneous closure of atrial septal defect in pediatric patients: a diffusion-weighted MRI study

“…Since the injection/flushing technique plays a crucial role in occurrence of air embolism, the cardiologists performing the catheterization took the following precautions to avoid introducing air through the sheath-catheter: 1) check the injector to make sure that it is oriented in nose-down direction, filled with saline, and free of air, 2) keep the proximal end of the catheter below the level of left atrium, 3) use Amplatzer septal occluder, as it has no side arms and avoids air embolism introduced by the side arms. The aortic arch atheroma and its contact with the catheter, duration of the procedure and the fluoroscopy have been reported as additional risk factors (9,19,20). In our patient group, other reasons for lack of cerebrovascular embolic events may include entry through the pulmonary veins only for the left heart catheterization, and not dealing with high-risk vessels for plaque embolization such as the aorta.…”

Cardio-ankle vascular index may be an important marker of silent neuronal injury after percutaneous coronary angiography and intervention: a prospective observational study on diagnostic accuracy

“…SNI is described in 18.5-23% of patients after cerebral angiography (11,12). Atherosclerotic thromboembolism due to catheter manipulation, thrombus formation on the catheter, air embolism and contrast agent may cause cerebral injury (12)(13)(14)(15). Moreover, increase in incidence of stroke in patients with history of PCI was reported in a previous study (10).…”