Neurological complications of cardiac catheterization

Aims. To describe the neurological complications of cardiac catheterization, together with its risk factors and pathogenic mechanisms. Method. Over the past few years there has been a marked increase in the number of interventions involving cardiac catheterizations. For this very reason, we can expect a proportional rise in the number of complications. The incidence of neurological pathologies secondary to heart interventions oscillates between 0.01 and 0.4% of procedures performed. The most frequent clinical pictures are cerebrovascular disease, neuro-ophthalmological syndromes and peripheral neuropathies, due to damage done to the median,femoral and lateral femoral cutaneous nerves, and to the lumbar plexus. The most usual mechanisms are cerebral ischemia originated by embolisms and direct compression of the peripheral nerves. Factors increasing the likelihood of complications are old age, the presence of classic vascular risk factors and, probably, the patient's being female. More risk is involved in mitral and aortic valvuloplasties and non-elective revascularization procedures. The personal experience of the operator and the overall activity of the department of haemodynamics where the physician works are factors that are very closely linked to the incidence of complications. Conclusions. Knowledge about neurological illness secondary to cardiac catheterization and its mechanisms of production may allow us to identify higher risk patients, to develop protocols to prevent it and to apply early therapeutic measures.