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Computed tomography detection of a cerebral calcific embolus following coronary catheterization
1Department of Anatomy, Oklahoma State University College of Osteopathic Medicine, Tulsa 74107-1898.
Insights
A rare case of calcified emboli causing stroke after aortic valve catheterization is presented. This highlights the risk of plaque dislodgement from severe aortic stenosis during cardiac procedures.
Area of Science:
- Cardiology
- Neurology
- Radiology
Background:
- Coronary artery angiography is a common diagnostic procedure.
- Calcified aortic stenosis poses challenges during catheterization.
- Cerebrovascular events can be a complication of cardiac interventions.
Observation:
- A 77-year-old man developed motor aphasia and right hemiparesis post-coronary angiography.
- Difficulty was encountered passing a catheter across a calcified aortic valve.
- Cranial computed tomography (CT) revealed a calcific density in the left middle cerebral artery.
Findings:
- The calcific plaque in the cerebral artery is believed to have originated from the aorta or aortic valve.
- This event represents a rare instance of spontaneous calcified emboli to cranial vessels.
- CT successfully detected the intracranial calcific plaque following the cardiac procedure.
Implications:
- This case underscores the potential risk of embolic complications from severe aortic calcification during cardiovascular procedures.
- Enhanced vigilance and potentially modified techniques may be warranted in patients with heavily calcified aortic valves.
- Further research into the incidence and prevention of such embolic events is suggested.
Abstract:
A 77-year-old man underwent coronary artery angiography quite well. However, several attempts were required to pass the pigtail catheter across a calcified stenotic aortic valve. On return to the floor, motor aphasia and right hemiparesis developed and improved steadily within a few days. Computed tomography (CT) of the head revealed a calcific density in the left middle cerebral artery. The authors believe the calcific plaque originated from the calcified aorta and aortic valve. The patient was discharged within 48 hours with minimal neurological signs. Spontaneous calcified emboli to cranial vessels from calcific aortic stenosis or other sources are rare. CT detection of a calcific plaque in a cranial vessel following coronary vessel catheterization is well documented in this patient.