Keilson G R, Schwartz W J, Recht L D
Department of Neurology, University of Massachusetts Medical Center, Worcester 01655.
Stroke. 1992 Sep;23(9):1358-9. doi: 10.1161/01.str.23.9.1358.
Central nervous system complications of cardiac catheterization are most often attributed to embolic events that occur at the time of catheter manipulation. Nevertheless, the reason that over 50% of these events are localized to the posterior circulation remains unexplained. One potential explanation offered for this preponderance is the use of the brachial artery approach. In this report, we examined the relation between the route of catheterization and central nervous system complications.
We retrospectively analyzed all central nervous system complications that occurred after cardiac catheterization through a femoral route at our institution over a 3 1/2-year period. Thirteen patients were identified as having central nervous system complications. Using defined criteria, posterior circulatory events still accounted for at least 54% of central nervous system complications.
The preponderance of posterior circulatory events is apparently independent of the route of catheterization. Furthermore, given the array of neurological symptoms and their often complete resolution, we feel it is unlikely that embolism is the sole pathophysiological mechanism involved in these events.
心导管插入术的中枢神经系统并发症大多归因于导管操作时发生的栓塞事件。然而，超过50%的此类事件局限于后循环的原因仍无法解释。对此优势现象提出的一种潜在解释是使用肱动脉入路。在本报告中，我们研究了导管插入途径与中枢神经系统并发症之间的关系。
我们回顾性分析了在我们机构3年半期间经股动脉途径进行心导管插入术后发生的所有中枢神经系统并发症。13名患者被确定患有中枢神经系统并发症。根据既定标准，后循环事件仍至少占中枢神经系统并发症的54%。
后循环事件的优势显然与导管插入途径无关。此外，鉴于一系列神经症状及其通常完全缓解的情况，我们认为栓塞不太可能是这些事件所涉及的唯一病理生理机制。
