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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
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Stroke and spinal infarct caused by percutaneous coronary intervention
Jeffrey Spindel1, Dipan Karmali2, Elizabeth Chen3
1Internal Medicine, University of Louisville, Louisville, Kentucky, USA jeffrey.spindel@louisville.edu.
BMJ Case Reports
|July 2, 2020
Summary
Percutaneous coronary intervention (PCI) can cause acute ischemic stroke, a rare but severe complication. This case highlights a patient experiencing both stroke and spinal infarction after PCI, emphasizing the need for vigilance in high-risk individuals.
Area of Science:
- Cardiology
- Neurology
- Interventional Cardiology
Background:
- Acute ischemic stroke is a recognized complication of percutaneous coronary intervention (PCI).
- The incidence of PCI-related stroke has risen due to increased patient comorbidities and procedural complexity.
- While overall stroke incidence post-PCI is low (0.56%), certain patient groups face significantly higher risks.
Observation:
- A 71-year-old woman presented with non ST-elevation myocardial infarction.
- Following PCI, she experienced both cerebral stroke and spinal infarction.
- These events were attributed to a thromboembolic event.
Findings:
- The patient developed significant long-term debility as a result of the stroke and spinal infarction.
- Risk factors for post-PCI stroke include atherosclerosis, atrial fibrillation, cardiogenic shock, advanced age, and arterial disease.
- Spinal infarctions following PCI are exceptionally rare.
Implications:
- This case underscores the potential for severe neurological complications, including rare spinal cord involvement, after PCI.
- Highlights the importance of identifying and managing risk factors in patients undergoing PCI.
- Emphasizes the significant morbidity, mortality, and cost associated with even infrequent PCI-related neurological events.
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