Acute pontine infarction after percutaneous coronary intervention: a very rare but devastating complication

F Arslan,J Mair,L Van Lelyveld,M Otten,W.-M Franz

doi:10.1007/s12471-015-0717-2

Abstract

A 64-year-old man suffering from an acute posterior wall myocardial infarction underwent primary percutaneous coronary intervention. After several aspiration attempts, tirofiban infusion and pre- and post-dilatation, a bare-metal stent was successfully implanted in the culprit right coronary artery. While the patient did not show any neurological symptoms before or during the procedure, he exhibited hemiplegia and loss of spontaneous speech. Additional magnetic resonance imaging showed an extensive brain stem infarction. This is the first report of a brain stem infarction as a complication of percutaneous coronary intervention.Electronic supplementary materialThe online version of this article (doi:10.1007/s12471-015-0717-2) contains supplementary material, which is available to authorized users.

Highlights

Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users
We present a case of a 64-year-old man, without any history of cardiovascular risk factors or other comorbidities, who underwent acute percutaneous coronary intervention (PCI) for an acute posterior wall myocardial infarction
After several aspiration attempts and intracoronary administration of tirofiban, the right coronary artery could be reopened with several pre-dilatations and implantation of a Driver Sprint bare-metal 4.5 15-mm stent (Medtronic Inc, Minnesota, USA) with subsequent 5.0 NC balloon post-dilatation

Summary

Introduction

Electronic supplementary material The online version of this article (doi:10.1007/s12471-015-0717-2) contains supplementary material, which is available to authorized users. F. Arslan ( ) Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands e-mail: f.arslan@umcutrecht.nl F. Arslan Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands Franz Department of Internal Medicine III—Cardiology and Angiology, Innsbruck Medical University, Innsbruck, Austria

Results

Conclusion