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(Stroke. 2007;38:2370.)
© 2007 American Heart Association, Inc.

Research Letters

Coronary Catheterisation Does Not Lead to Retinal Artery Emboli in Short-Term Follow-Up of Cardiac Patients

Isaac Thyer, BE, MBBS; Pramesh Kovoor, PhD, FRACP; Jie Jin Wang, MMed, PhD; Bronwen Taylor, BTech; Annette Kifley, MBBS, MAppStat; Richard Lindley, MD, FRACP; Paul Mitchell, MD, PhD Aravinda Thiagalingam, PhD, FRACP

From the University of Sydney Medical Program (I.T.), University of Sydney; the Cardiology Department (P.K., A.T.), University of Sydney, Westmead Hospital; the Centre for Vision Research (J.J.W., B.T., A.K., P.M.), Department of Ophthalmology, University of Sydney; and the Discipline of Medicine (R.L.), University of Sydney, Westmead Hospital, Australia.

Correspondence to Pramesh Kovoor, Cardiology Department, Building 9, Westmead Hospital, Hawkesbury Rd, Westmead, NSW, Australia 2145. E-mail kovoor{at}westgate.wh.usyd.edu.au

Abstract

Background and Purpose— There is emerging evidence that coronary catheterization can cause cerebrovascular embolization. We aimed to assess the proportion of cardiac patients with retinal emboli before coronary catheterization and the proportion with newly developed retinal embolism shortly after coronary catheterization.

Methods— Ninety-seven patients attending Westmead Hospital for coronary catheterization between December 2005 and February 2006 were recruited. Medical history, physical examination, and pre- and postcatheterization photography of 5 retinal fields was performed. The proportion of patients with new retinal emboli was assessed by comparing post- and precatheterization retinal photographs.

Results— Before catheterization, retinal emboli were observed in 5 patients (5.2%) and were significantly associated with higher body mass index (P=0.007). The presence of angiographic coronary artery disease was not significantly associated with preexisting retinal emboli. In 97 patients, we found no new emboli within the 16-hour (median: range 4 to 45 hours) postcoronary catheterization period.

Conclusions— Asymptomatic retinal emboli are relatively common in patients being assessed for coronary artery disease. We found no evidence suggesting coronary catheterization contributes to retinal embolism shortly after the procedure.

Key Words: catheter • coronary • coronary artery disease • embolus • retina • stroke