PCI complications: distal embolization
Page: PCI Complications: Distal Embolization
Editor(s)-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Alexandra Almonacid, M.D. [2]; Jeffrey J. Popma, M.D. [3]
Definition
Clinical distal embolization during PCI is defined as the evidence of peri-procedural myonecrosis, while angiographic distal embolization is known as the migration of a filling defect or thrombus to distally occlude the target vessel or one of its branches.[1]
Incidence
Distal embolization occurs in approximately 10% of patients with an acute myocardial infarction undergoing PCI. Embolic complications occur more often in patients with acute MI and in patients undergoing balloon angioplasty of SVG lesions, particularly those with recent occlusion.
Air Embolus
- Often from manifold injections (contrast or flush); increase risk with pressurized flush
- Small amount well tolerated; larger amount causes air-lock
- Treatment: 100% O2, Narcotics, Suction vs hemopump, and Verapamil
Coronary Angiography: Distal Embolization
References
- ↑ Ishizaka N, Issiki T, Saeki F, Furuta Y, Ikari Y, Yamaguchi T (1994). "Predictors of myocardial infarction after distal embolization of coronary vessels with percutaneous transluminal coronary angioplasty. Experience of 21 consecutive patients with distal embolization". Cardiology. 84 (4–5): 298–304. PMID 8187116.
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