Premium
Potential embolization by atherosclerotic debris dislodged from aortic wall during cardiac catheterization:: Histological and clinical findings in 7,621 patients
Author(s) -
Eggebrecht Holger,
Oldenburg Olaf,
Dirsch Olaf,
Haude Michael,
Baumgart Dietrich,
Welge Dirk,
Herrmann Joerg,
Arnold Georg,
Werner Schmid Kurt,
Erbel Raimund
Publication year - 2000
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/(sici)1522-726x(200004)49:4<389::aid-ccd8>3.0.co;2-5
Subject(s) - medicine , embolization , catheter , thrombus , cardiac catheterization , lumen (anatomy) , aorta , radiology , cardiology , ascending aorta , surgery
Embolic events during cardiac catheterization have been attributed to atherosclerotic aortic debris dislodged by catheter manipulation. We evaluated the frequency and the histologic morphology of atherothrombotic material retrieved during placement of coronary catheters in patients undergoing diagnostic or interventional cardiac procedures. Over a 4‐year period, macroscopically visible aortic debris from coronary catheters, if present after advancement to the ascending aorta, was obtained for histologic examination. In 41 of 7,621 patients (0.54%), visible atherothrombotic material was present in the backflow of catheters. Debris occurred most frequently with 8 Fr guiding catheters (98%). Histologic examination showed foam cells, cholesterol crystals, and amorphic lipoid substance as markers of atheromatous material from atherosclerotic plaques in 38/41 patients (93%) with former plaque hemorrhage in 55% of them. In three patients, fresh thrombus material was observed (7%). None of these patients showed in‐hospital ischemic complications. Although visible atheromatous material is a rare phenomenon in cardiac catheterization, an increased risk of scraping debris is associated with large‐lumen guiding catheters. In order to avoid vascular embolization, the use of smaller guiding catheters and sufficient free backflow of catheters after advancement are recommended. Cathet. Cardiovasc. Intervent. 49:389–394, 2000. © 2000 Wiley‐Liss, Inc.