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Unexpected outcome (positive or negative) including adverse drug reactions
Case report
Stroke and spinal infarct caused by percutaneous coronary intervention
  1. Jeffrey Spindel1,
  2. Dipan Karmali1,
  3. Elizabeth Chen2 and
  4. Shahab Ghafghazi3
  1. 1Internal Medicine, University of Louisville, Louisville, Kentucky, USA
  2. 2College of Osteopathic Medicine, Marian University, Indianapolis, Indiana, USA
  3. 3Cardiology, University of Louisville, Louisville, Kentucky, USA
  1. Correspondence to Dr Jeffrey Spindel; jeffrey.spindel{at}louisville.edu

Abstract

Acute ischaemic stroke is a known risk of percutaneous coronary intervention (PCI). The incidence of such complications has increased in frequency over the last decade due to higher comorbidity burden and increased complexity of PCI procedures. The overall incidence of post-PCI ischaemic stroke remains low at 0.56%, but some groups of patients have significantly higher risk. Risk factors include atherosclerotic plaques, atrial fibrillation, cardiogenic shock, older age and arterial disease. Although the overall incidence of acute ischaemic stroke following PCI is low, it can result in lifelong disability and is associated with high morbidity, mortality and significant costs. Spinal infarctions due to PCI are exceedingly rare. Here, we discuss a 71-year-old woman who presented with a non ST-elevation myocardial infarction and developed both stroke and spinal infarction post PCI due to a thromboembolic event resulting in long-term debility.

  • interventional cardiology
  • ischaemic heart disease
  • spinal cord
  • neurological injury

http://dx.doi.org/10.1136/bcr-2020-234804

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    Footnotes

    • Contributors All authors were part of the cardiology team taking care of the patient and were directly involved in her care. DK formatted the images, their captions and interpretations. DK also contributed to the patient’s presentation section and anatomy of spinal infarction section. EC wrote the section on costs and outcomes of post PCI strokes, researched, and cited references and other case reports on spinal infarctions. JS edited and formatted the final manuscript for submission and specifically wrote the summary, background and concluding paragraphs. He also conceptualised the pathology and summarised statistics and current knowledge of post-PCI strokes. SG was the attending physician and oversaw all work. SG also conceptualised the original idea to write up and helped put the ideas onto paper and contributed directly to the patients presentation section and its interpretation. All of the authors agree to be accountable for all aspects of their work, ensuring that any questions related to the accuracy or integrity will be investigated and resolved. All authors have given their final approval of the version here submitted.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.