Athero-embolic isolated splenic infarction following left cardiac catheterization.
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.
Hussein
Ahmed
A
University of Maryland Medical Center, Maryland, Baltimore, USA.
Kasmani
Rahil
R
Irani
Farzan
F
Mohan
Geetali
G
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
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin