| Risk of catheter-related emboli in patients with atherosclerotic debris in the thoracic aorta. | |
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MedLine Citation:
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PMID: 8644594 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The aim of this study was to evaluate the risk of performing cardiac catheterization or intraaortic balloon pump placement in patients with transesophageal echocardiographically detected atherosclerotic aortic debris. Cardiac catheterization was performed in 70 patients with atherosclerotic aortic debris (in 11 via the brachial approach and in 59 via the femoral approach) and in 71 control patients. An embolic event occurred in 10 (17%) of 59 patients with atherosclerotic aortic debris after femoral catheterization compared to 2 (3%) of 71 control patients without atherosclerotic aortic debris (p = 0.01). None of the 11 patients with atherosclerotic aortic debris who underwent brachial catheterization had an embolic event. An intraaortic balloon pump was placed in 10 patients with atherosclerotic aortic debris and in 12 control patients. An embolic event related to placement of the intraaortic balloon pump occurred in 5 (50%) of 10 patients with atherosclerotic aortic debris; no control patient had an embolic event (p = 0.02). Patients with mobile atherosclerotic aortic debris were at the highest risk for catheter-related embolism. The strongest clinical predictors of atherosclerotic aortic debris were advanced age and peripheral vascular disease. Transesophageal echocardiographic recognition of atherosclerotic aortic debris identifies patients at high risk of stroke or peripheral embolism after cardiac catheterization or intraaortic balloon pump placement. If the aortic debris is mobile, the risk is particularly high. When atherosclerotic aortic debris is detected, especially if the debris is mobile, substituting brachial for femoral catheterization and avoiding placement of an intraaortic balloon pump may reduce the risk of embolism. |
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Authors:
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D G Karalis; V Quinn; M F Victor; J J Ross; M Polansky; K A Spratt; K Chandrasekaran |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 131 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1996 Jun |
Date Detail:
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Created Date: 1996-07-16 Completed Date: 1996-07-16 Revised Date: 2006-02-27 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1149-55 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiovascular Diseases, Hahnemann University Hospital, Philadelphia, PA 19102, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Aged Aged, 80 and over Aorta, Thoracic Aortic Diseases / complications*, ultrasonography Arteriosclerosis / complications*, ultrasonography Catheters, Indwelling / adverse effects* Echocardiography, Transesophageal Embolism / etiology* Heart Catheterization / adverse effects Humans Intra-Aortic Balloon Pumping / adverse effects Logistic Models Middle Aged Peripheral Vascular Diseases / complications Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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