Document Detail


Transient contrast encephalopathy after carotid artery stenting.
MedLine Citation:
PMID:  11357968     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report an unusual case of transient contrast encephalopathy arising after carotid artery stenting. CASE REPORT: An 82-year-old right-handed man with a recent history of transient ischemic events was admitted to the hospital for evaluation of carotid artery disease. During cerebral angiography, which identified a 90% right internal carotid artery stenosis, the patient received 25 mL of an ionic, low-osmolar contrast agent (ioxaglate) in each carotid artery. The following day he underwent successful carotid stenting, during which 180 mL of ioxaglate were used. He developed rapidly worsening confusion and left hemiparesis on the table. Noncontrast computed tomography showed marked cortical enhancement and edema of the right cerebral hemisphere in the distribution of the right anterior and middle cerebral arteries. The patient improved rapidly and by day 2 was completely recovered; magnetic resonance imaging documented no cortical edema and normal sulci. One month after the procedure, he was well, with patent carotid arteries. CONCLUSIONS: Transient neurotoxicity after carotid interventions must be differentiated from massive cerebral infarction and hyperperfusion syndrome, but the prognosis is excellent. However, subsequent contrast studies in a patient with this complication should be undertaken with extreme caution.
Authors:
G Dangas; L H Monsein; R Laureno; M A Peterson; J R Laird; L F Satler; R Mehran; M B Leon
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  8     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-05-18     Completed Date:  2001-10-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  111-3     Citation Subset:  IM    
Affiliation:
Cardiovascular Research Foundation, Lenox Hill Heart & Vascular Institute, New York, New York 10022, USA. gdangas@crf.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Carotid Arteries / surgery*
Contrast Media / adverse effects*
Humans
Male
Neurotoxicity Syndromes / etiology*
Stents*
Chemical
Reg. No./Substance:
0/Contrast Media

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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