Embolization from angiographic catheter during angiography simulating vascular spasm. Report of a case with postmortem verification.

The initiating event in the pathogenesis of acute coronary thrombosis, especially the role played by vasospasm, remains controversial. Recently an angiographic sequence of events has been reported which should conclusively prove that spasm of a normal coronary artery might lead to occlusive thrombosis. The patient survived, and thus this conclusion was reached without morphological verification. The present report describes an almost identical angiographic sequence of events in a cerebral artery initially interpreted in the same way: spasm leading to thrombosis. The patient died, and an embolus derived from the angiographic catheter was found at postmortem examination exactly where angiography had shown "spasm". A "catheter embolus" simulating vascular spasm could as well explain the basic angiographic findings in the previously reported case. Thus, it still remains to be proved that spasm of a normal artery may lead to occlusive thrombosis.