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A rare complication of percutaneous coronary artery intervention
  1. Wai Sun Choo,
  2. Badusha Abdul Kareem Barakath,
  3. Boon Keat Tan,
  4. Omar Ismail
  1. waisun76{at}yahoo.com

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Introduction

Coronary angiogram and PCI are common procedures performed daily in cardiac centres. Vascular complications are well known to occur during and after these procedures. We would like to report a rare postprocedural complication of percutaneous coronary artery intervention.

Case report

A 40-year-old man with underlying type 2 diabetes mellitus, hypertension and gouty arthritis presented to our hospital in October 2008 with an acute inferior myocardial infarction. He was successfully treated with intravenous thrombolytics and was discharged. His outpatient exercise stress test was strongly positive, so arrangements were made for an elective coronary angiogram.

The coronary angiogram revealed two-vessel disease—distal RCA 70% stenosis and proximal LAD 80% stenosis. The left main stem and the circumflex artery were normal. Percutaneous coronary angioplasty and stenting (PCI) to the proximal LAD were performed. Besides raised blood pressure measurements (systolic 200–180, diastolic 100–110), which were treated with intravenous calcium antagonist and nitrates, the procedure was uncomplicated and successful. A renal angiogram revealed no abnormalities. The patient remained asymptomatic throughout the procedure. The total procedure time and intravenous contrast media usage (Ultravist-370) was 90 min and 200 ml respectively.

During routine post-PCI review in the ward, the patient complained of giddiness, headache and bilateral blurring of vision. There were no other associated …

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