Brain "embolism" detected by magnetic resonance imaging during percutaneous mitral balloon commissurotomy.

Details

Serval ID
serval:BIB_8A389FDC9D66
Type
Article: article from journal or magazin.
Collection
Publications
Title
Brain "embolism" detected by magnetic resonance imaging during percutaneous mitral balloon commissurotomy.
Journal
Cardiovascular and Interventional Radiology
Author(s)
Rocha P., Qanadli S.D., Strumza P., Kacher S., Aberkane L., Aubry P., Rigaud M., Lacombe P., Raffestin B.
ISSN
0174-1551
Publication state
Published
Issued date
06/1999
Peer-reviewed
Oui
Volume
22
Number
3
Pages
268-73
Language
english
Notes
Corrected and Republished Article Rocha, P Qanadli, S D Strumza, P Kacher, S Aberkane, L Aubry, P Rigaud, M Lacombe, P Raffestin, B United states Cardiovascular and interventional radiology Cardiovasc Intervent Radiol. 1999 May-Jun;22(3):268-73. --- Old month value: May-Jun
Abstract
PURPOSE: The common finding of thrombi between the bifoil balloons when they were extracted after mitral dilation prompted us to look for evidence of minor brain embolisms using the sensitive technique of BMRI (brain magnetic resonance T2-weighted imaging). METHODS: BMRI was performed within 48 hr before and after a percutaneous mitral balloon commissurotomy (PMBC) in each of the 63 patients in this study. RESULTS: There was evidence (hyperintensity foci: HI) of a previous asymptomatic brain embolism in 38 of 63 patients before PMBC and a new HI appeared in 18 of 63 patients after the procedure. New HI signals were found exclusively in the white matter in 8 of 18 patients and in only 3 of 18 were HI signs larger than 1 cm. One patient, with an HI signal > 1 cm in the thalamus and another < 1 cm in the brain stem, presented diplopia accompanied by other minor clinical signs. The differences in HI rate among four subgroups (1, older vs younger than 43 years; 2, sinus rhythm vs atrial fibrillation; 3, echo score < 8 vs > 8; 4, patients from western countries vs the others) were not statistically significant, probably because the number of patients in each subgroup was low. Patients in atrial fibrillation had slightly more (not significant) HI before PMBC (15/20, 75%) than patients in sinus rhythm (23/43, 53%), but after PMBC their HI frequencies were similar (atrial fibrillation: 5/20, 25%; sinus rhythm: 13/43, 30%). CONCLUSION: Brain microembolism is frequent during PMBC, but is often anatomically limited and free from clinical signs in most cases. Brain embolism seems to be related mainly to the procedure itself and not the features of the patient.
Keywords
Adult, Balloon Dilatation/adverse effects, Brain/pathology, Case-Control Studies, Female, Humans, Intracranial Embolism and Thrombosis/diagnosis, Intracranial Embolism and Thrombosis/epidemiology, Magnetic Resonance Imaging, Male, Mitral Valve Stenosis/therapy, Rheumatic Heart Disease/therapy, Time Factors
Pubmed
Web of science
Open Access
Yes
Create date
09/04/2008 16:12
Last modification date
20/08/2019 14:49
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