TY - JOUR
T1 - Potential embolization by atherosclerotic debris dislodged from aortic wall during cardiac catheterization
T2 - Histologic and clinical findings in 7,621 patients
AU - Eggebrecht, Holger
AU - Oldenburg, Olaf
AU - Dirsch, Olaf
AU - Haude, Michael
AU - Baumgart, Dietrich
AU - Welge, Dirk
AU - Herrmann, Joerg
AU - Arnold, Georg
AU - Schmid, Kurt Werner
AU - Erbel, Raimund
PY - 2000
Y1 - 2000
N2 - 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. (C) 2000 Wiley- Liss, Inc.
AB - 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. (C) 2000 Wiley- Liss, Inc.
KW - Aortic plaque
KW - Coronary interventions
KW - Embolization
KW - Guiding catheter
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U2 - 10.1002/(SICI)1522-726X(200004)49:4<389::AID-CCD8>3.0.CO;2-5
DO - 10.1002/(SICI)1522-726X(200004)49:4<389::AID-CCD8>3.0.CO;2-5
M3 - Article
C2 - 10751762
AN - SCOPUS:0034038264
SN - 1522-1946
VL - 49
SP - 389
EP - 394
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 4
ER -