stroke due to cardiac catheterization procedure

Q: Which of the following is NOT considered a risk factor for stroke after cardiac catheterization? - select one

A) Emergency procedure

B) Longer procedure time

C) Radial artery access

D) Greater contrast use

E) Deploying intra-aortic balloon pump

Answer: C

Although relatively less acknowledged, stroke due to the cardiac catheterization procedure is relatively common. Both ischemic and hemorrhagic strokes can occur. Risk factors include:

• Older age 
• Hypertension
• Diabetes mellitus
• History of stroke
• Kidney failure
• Heart failure
• Severe coronary artery atherosclerotic disease
• Coronary artery thrombus
• Carotid artery disease
• Emergent procedure, including acute coronary syndrome
• Longer procedure time
• Greater contrast use
• Retrograde catheterization of the left ventricle in patients with aortic stenosis
• Interventions at bypass grafts
• Use of an intra-aortic balloon pump
• Use of anticoagulation or thrombolytic agents for acute myocardial infarction

Either transfemoral or transradial access has a similar risk of stroke due to the cardiac catheterization procedure.

#procedures

#cardiology

References:

1. Feng YQ, He XY, Song FE, Chen JY. Association between Contrast Media Volume and 1-Year Clinical Outcomes in Patients Undergoing Coronary Angiography. Chin Med J (Engl). 2018 Oct 20;131(20):2424-2432. doi: 10.4103/0366-6999.243563. PMID: 30334527; PMCID: PMC6202589.

2. Korn-Lubetzki I, Farkash R, Pachino RM, Almagor Y, Tzivoni D, Meerkin D. Incidence and risk factors of cerebrovascular events following cardiac catheterization. J Am Heart Assoc. 2013 Nov 14;2(6):e000413. doi: 10.1161/JAHA.113.000413. PMID: 24231658; PMCID: PMC3886771.

3. Tanaka A, Node K. Prediction of Stroke After Cardiac Catheterization: No Reason, No Stroke. J Atheroscler Thromb. 2018 Mar 1;25(3):221-223. doi: 10.5551/jat.ED086. Epub 2017 Sep 20. PMID: 28931783; PMCID: PMC5868507.