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E-068 Spinal Cord Infarction After Bronchial Artery Embolisation
  1. A Jammoul1,
  2. M Hussain2
  1. 1Adult Neurology, Cleveland Clinic Foundation, Cleveland, OH
  2. 2Vascular Neurology, Cleveland Clinic Foundation, Cleveland, OH

Abstract

Introduction Bronchial artery emoblisation (BAE) has been shown to be an effective and successful approach to control massive haemoptysis. One of the most feared complications of this procedure is spinal cord injury secondary to embolisation of a radicular artery. Superselective microcatheter usage has been thought to reduce that complication. Herein, we report a case of thoracic spinal cord infarction despite the usage of a microcatheter.

Methods Case Report.

Results A 44-year old woman with a history of stable cervical spinal stenosis, pulmonary sarcoidosis and aspergilloma complicated by recurrent haemoptysis from the left upper lobe underwent a successful bronchial artery embolisation with 500–700 µm embospheres. A few hours after the completion of the procedure, she developed symptoms of left leg weakness, right truncal and leg numbness and urinary hesitancy, all of which waxed and waned over a period of a few days. MRI of the cervical and thoracic spine with gadolinium enhancement sequences, performed 3 days after symptom onset, showed the presence of an infarct in the left paracentral cord at the level of T1 (figure 1). DWI sequences were also performed and corroborated that finding (images not shown). She markedly improved 4 days after symptom onset and was discharged home.

Conclusion Spinal cord injury after bronchial artery embolisation has been reported to occur at a prevalence of 1.4-6.5%. Newer reports have documented a much lower prevalence with the advent of superselective microcatheter usage. This report underscores the importance of recognising such a complication after BAE despite microcatheter usage.

Abstract E-068 Figure 1
Abstract E-068 Figure 1

MRI of the spine. Sagittal T2 weighted imaging (left) shows, in addition to a stable C4-C5 level myelomalacia, a new 7-mm T2 hyperintensity in the thoracic spine at the level of T1, which was located on the left as per the axial T2 weighted imaging (right).

Disclosures A. Jammoul: None. M. Hussain: None.

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