title: Autopsy demonstration of intramyocardial polymer gel emboli associated with a giant-cell reaction following cardiac catheterization: a case report.
abstract: BACKGROUND
  Foreign body type granulomatous vasculitis has been reported in blood vessels of the brain, lungs, and skin of the foot following intravascular instrumentation with devices coated with hydrophilic polymer gel. We report a case of intramyocardial polymer gel emboli associated with granulomatous vasculitis following cardiac catheterization.
  
  
  METHODS
  Autopsy observations in a 77-year-old woman are presented. The patient experienced an acute myocardial infarction requiring catheterization and coronary stenting. The patient returned with a pseudoaneurysm at the site of catheterization and shortly after suffered a fatal arrhythmia.
  
  
  RESULTS
  Microscopically, multiple small vessels within the myocardium were noted to contain a basophilic, amorphous, focally lamellated, focally granular material. A granulomatous inflammatory response was noted in the vessels containing the foreign material.
  
  
  CONCLUSIONS
  Our case is the first to our knowledge to document intramyocardial vessel gel emboli following a cardiac catheterization with stenting. Although the microscopic finding of emboli within vessels does not seem to be the immediate cause of death in our case, it is highly possible that it contributed to the patient's demise.
authors: Department of Pathology, Mount Sinai Medical Center, Miami Beach, Florida, USA.
authors: Vicky
authors: V
authors: El-Najjar
authors: Morton
authors: M
authors: Robinson
mesh_terms: D000368:Aged; D001344:Autopsy; D002404:Catheterization / Q000009:adverse effects*; D004617:Embolism / Q000209:etiology / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D005782:Gels / Q000009:adverse effects; D015743:Giant Cells, Foreign-Body / Q000473:pathology*; D015745:Granuloma, Foreign-Body / Q000209:etiology / Q000473:pathology*; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000473:pathology; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D009206:Myocardium / Q000473:pathology*; D011108:Polymers / Q000009:adverse effects; D015607:Stents
chemical_list: D005782:Gels; D011108:Polymers