title: The preponderance of posterior circulatory events is independent of the route of cardiac catheterization.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurology, University of Massachusetts Medical Center, Worcester 01655.
authors.forename: G R
authors.initials: GR
authors.lastname: Keilson
authors.forename: W J
authors.initials: WJ
authors.lastname: Schwartz
authors.forename: L D
authors.initials: LD
authors.lastname: Recht
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000379:methods; D002493:Central Nervous System Diseases / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors