title: Athero-embolic isolated splenic infarction following left cardiac catheterization.
abstract: Instrumentation of the aorta during cardiac catheterization, resulting in peripheral embolization, is an underdiagnosed clinical entity. Such an atheromatous embolization can present in a subtle way or could be catastrophic. Isolated splenic infarction as a complication of the procedure is extreme rare. We report a 59-year-old man with risk factors for atherosclerotic vascular disease who underwent percutaneous coronary intervention and presented 3 days later with isolated splenic infarction. He was managed conservatively with heparin. Further evaluation revealed a concomitant mural thrombus in an abdominal aortic aneurysm, which could be a contributing factor along with atheroembolization from advanced atherosclerosis. Our case highlights the importance of using a right brachial or radial approach in an individual with significant atherosclerotic vascular disease and with an abdominal aortic aneurysm.
authors.affiliation: University of Maryland Medical Center, Maryland, Baltimore, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hussein
authors.forename: Rahil
authors.initials: R
authors.lastname: Kasmani
authors.forename: Farzan
authors.initials: F
authors.lastname: Irani
authors.forename: Geetali
authors.initials: G
authors.lastname: Mohan
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D000925:Anticoagulants / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery; D001241:Aspirin / Q000627:therapeutic use; D050197:Atherosclerosis / Q000150:complications; D006328:Cardiac Catheterization / Q000009:adverse effects*; D000077144:Clopidogrel; D023921:Coronary Stenosis / Q000628:therapy*; D017700:Embolism, Cholesterol / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D013154:Spleen / Q000098:blood supply*; D013927:Thrombosis / Q000150:complications; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin