Cerebral microembolism following coronary angiography -A prospective comparative study between left cardiac catheterization and multidetector computed tomography-

Abstract

Objective Left cardiac catheterization carries a risk of cerebral complications. We aimed to conduct a prospective comparative study to determine the frequency and clinical implications of cerebral microembolism following left cardiac catheterization. Methods One hundred and sixty-seven patients were enrolled into two groups: 111 patients who underwent left cardiac catheterization and 56 patients who underwent multidetector computed tomography (MDCT). MRI was performed within seven days after cardiac catheterization or MDCT, and acute cerebral embolism was detected on diffusion-weighted imaging (DWI). Old cerebral infarctions were detected on the initial T2- weighted imaging (T2WI), and new cerebral infarctions were detected on T2WI three months after the first MRI. Results On the initial MRI examinations, DWI-positive areas were observed in 20 cases (18%) and T2WIpositive areas were observed in only two cases (1.8%) after three months in the patients who underwent left cardiac catheterization. DWI-positive areas were observed in only one case (1.8%) after MDCT, while no T2WI-positive areas were observed three months later. No neurological abnormalities were detected in any patients with DWI-positive areas. Conclusion Left cardiac catheterization carries a risk of asymptomatic cerebral microembolism, as assessed on DWI; however, most microemboli disappear within three months without causing any neurological abnormalities. © 2013 The Japanese Society of Internal Medicine.