PT217 Catheterization-Related Cerebral Infarction Evaluated At Diffusion-Weighted Magnetic Resonance Imaging In High-Risk Patients

Abstract

Introduction: Stroke related with catheterization was devastating complications after procedures. The rates of stroke range from 0.1-0.4% according to previous studies. Stroke was taken only as new neurological complications, therefore clinically unapparent cerebral embolisms were not taken into account. Diffusion weighted magnetic resonance imaging (DW-MRI) is very high sensitive tools for detecting acute cerebral ischemic lesions. Due to improvements of catheter design and approach, catheterization-related cerebral infarctions are expected to decrease, whereas this may be counterbalanced by increased risk profile of patients who undergo catheterization. Objectives: We aimed to examine the current prevalence and risk factors of symptomatic and asymptomatic catheterization-related cerebral infarctions by DW-MRI. Methods: We retrospectively analyzed 84 patients who underwent 1237 diagnostic and interventional catheterization procedures through the aortic arch conducted within 2010 and 2011 in our hospital and who obtained the MRI within 14 days a catheterization. Results: Ten patients who developed symptoms and 3 patients were finally diagnosed as stroke, which was defined as any neurological deficits lasting over 24 hours. The remaining 74 patients were asymptomatic and underwent MRI for various other reasons, including the assessment before coronary artery bypass graft (35%), valvular surgery (18%) or aortic repair (6.8%). The MRI revealed a fresh cerebral infarction in 22 of 74 asymptomatic patients (29.7%). Patients with cerebral infarction underwent longer procedures (mean SEM, 17.1 1.7 minutes vs. 22.7 2.4 minutes, p<0.05), used higher number of catheters and were more likely to be old (mean SEM, 74.1 1.67 vs. 70.4 1.1 years old), to have dyslipidemia, and to undergo in urgent settings and for interventional purposes. In DW-MRI findings, more patients with new infarction had multiple or bilateral lesions. More lesions were seen in the anterior and anterior plus posterior territories. Conclusion: Stroke after catheterization occurred 3 of 1237 (0.16%) patients, and this rate was almost equivalent to those seen in previous studies. However, the rate of small asymptomatic catheterization-related cerebral infarctions detected using diffusion-weighted MRI remains high in high-risk patients or candidates for cardiac surgery. Disclosure of Interest: None Declared