Acute ischemic stroke during cardiac catheterization: a rare case report in Malaysia

Acute stroke occurring during cardiac catheterization is an extremely uncommon procedural complication. There is a significant research gap in the published literature regarding the occurrence of acute ischemic stroke during percutaneous coronary intervention in Asian populations, with most data originating from western countries, underscoring the need for localized studies to develop tailored detection and management strategies. We present the case of a 70-year-old Indian woman with multiple cardiovascular risk factors who experienced an acute ischemic stroke while undergoing percutaneous coronary intervention in Malaysia. We hypothesized that the clinically relevant cerebral infarction might have originated from large plaques located along the aortic arch. Catheterization-related strokes caused by embolization of fresh thrombi forming at the catheter or guidewire tips should be thrombolysed. Choosing the transradial approach reduces stroke risk but requires careful use of appropriately sized instruments and meticulous handling of guidewires to ensure patient safety.