[Transient cortical blindness following cardiac catheterization: an alarming but infrequent complication with a good...

Transient cortical blindness is a rare complication of using an angiographic contrast agent. Its incidence following cardiac catheterization is low and has been studied scarcely. This article describes our experience with this condition and compares it with the findings of a review of published reports. Although the clinical characteristics of the onset and development of the condition are well-defined, its occurrence usually causes great alarm, in both patients and interventional cardiologists. It occurs more frequently in patients with an internal mammary artery graft and in those undergoing extended procedures. Etiologically, it appears to be related to the direct toxic effects of an accumulation of contrast in lower body areas during prolonged supination. Contrast can leak through the vertebral arteries during internal mammary artery catheterization. The condition resolves completely within a few days. Further investigations using contrast are not contraindicated.