Delayed cerebral ischemia following arteriography.
Cerebral ischemic events associated with arteriography are usually attributed to catheter-induced emboli. We present three patients with cerebral ischemia occurring 6 to 48 hours post-arteriography. We suspected that alternate pathogenic mechanisms were in effect. To evaluate the possibility that sustained platelet activation occurs in association with arteriography, we measured the platelet-specific protein beta thromboglobulin (BTG) prior to and 24 hours following arteriography in two groups of patients. Group I had arteriography performed shortly after venipuncture, while Group II patients did not have arteriography between samples. Seven of eight Group I patients had an increase of BTG on day two, compared with two of eight group II patients (p less than 05). When compared to Group II changes, Group I had a significant increase of BTG on day two (p less than .05). We conclude that cerebral ischemic events associated with arteriography may occur on a delayed basis, and that platelet activation, manifested by increased BTG levels, may be one mechanism contributing to this phenomenon.
Fisher
M
M
Sandler
R
R
Weiner
J M
JM
D000328:Adult; D000368:Aged; D000792:Angiography / Q000009:adverse effects*; D002545:Brain Ischemia / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation; D013997:Time Factors; D001620:beta-Thromboglobulin / Q000097:blood
D001620:beta-Thromboglobulin