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A unique complication during coronary angiography: peripheral embolism by selective right coronary engagement--a case
1Medizinische Klinik II, Universitätsklinikum Lübeck, Germany. drdeepakjain@hotmail.com
Insights
Coronary angiography can rarely cause arterial embolism. In this case, a right coronary artery thrombus embolized to the leg artery after catheter engagement during treatment for myocardial infarction.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Peripheral embolisms during coronary angiography are uncommon.
- Typically, emboli originate from the aorta or left heart chambers.
- Acute myocardial infarction necessitates coronary angiography.
Purpose of the Study:
- To report a rare case of peripheral embolism originating from the coronary arteries.
- To identify the source and precipitating cause of the embolism.
- To review existing literature on coronary angiography-induced emboli.
Main Methods:
- Coronary angiography was performed for acute inferior myocardial infarction.
- Selective engagement of the right coronary artery with a Judkins right catheter.
- Diagnosis of acute left common femoral artery embolism.
Main Results:
- A thrombus within the right coronary artery was identified as the embolus source.
- Selective catheter engagement precipitated the embolism.
- The patient experienced acute embolism of the left common femoral artery.
Conclusions:
- The coronary arteries, specifically a thrombus-filled right coronary artery, can be a source of peripheral emboli.
- Selective catheterization can precipitate coronary artery embolism.
- This case expands the understanding of embolic sources during coronary angiography.
Abstract:
"Micro" and "macro" peripheral embolisms during coronary angiography have been described. In all these cases, the aorta or the left heart chambers have been the source of embolus. A patient who during coronary angiography for acute inferior myocardial infarction experienced acute embolism of the left common femoral artery. The source of the embolus was a thrombus-filled right coronary artery, and the precipitating cause was its selective engagement with a diagnostic Judkins right catheter. A brief review of literature is also presented.