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Category: Volume 07 Issue 08 August 2019
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Title: Incidence of Ocular Symptoms Following Percutaneous Coronary Procedures- A Single Centre Experience

Authors: Suresh Madhavan, Gargi Sathish, Jayaprasad N, V.Sudhakumary, Elizabeth John, Raihanathul Misiriya, K.Jayaprakash, V.L.Jayaprakash, Raju George

 DOI: https://dx.doi.org/10.18535/jmscr/v7i8.134

Abstract

        

Aim of the study: To find the incidence of new ocular symptoms following transradial diagnostic and therapeutic coronary catheterization and associated risk factors.

Materials & Methods: Prospective observational study of 500 consecutive patients satisfying the inclusion criteria attending our tertiary health centre for transradial coronary procedures were observed for post procedural new ocular symptoms and compared with 500 patients undergoing same via transfemoral approach.

Results: 76 patients (incidence 7.6%) developed new ocular symptoms in the form of black-outs, Amaurosis fugax and field loss. 75% of these patients belonged to radial access group. 40 patients had reversible visual symptoms as a sequalae of cerebral hypo perfusion and 36 patients had symptoms of retinal embolism. Clinically apparent changes in vision was noted in 9 [0.9%] patients. In those with new ocular symptoms, the risk factors found were age, periprocedural hypertension, vascular tortuosity, procedure done through radial artery approach in patients with height<155cm ,prolonged procedural time. 1patient had uniocular Central Retinal Artery Occlusion [CRAO] with permanent loss of vision. 3 patients had features of Branch Retinal Artery Occlusion [BRAO] and 5 patients had peripheral retinal embolus.

Conclusions: Although rare, incidence of ocular embolic complications were higher with percutaneous coronary procedures via radial approach. Patients with height <155 cm may be benefitted when the procedure is done via femoral approach. Cardiologists should try to avoid excessive catheter manipulations while doing procedures. Prompt diagnosis and treatment may reduce extent of damage caused by vascular embolism.

Keywords: Ocular embolism, coronary angiography, coronary angioplasty.

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Corresponding Author

Dr Gargi Sathish

Associate Professor, Government Medical College, Kottayam, Kerala, India 686008