Hydrophilic polymer emboli: an under-recognized iatrogenic cause of ischemia and infarct

• DOI: 10.1038/modpathol.2010.74
• Publication Date: 2010-03-19T15:04:19Z
• Authors: Rupal I Mehta; Rashi I Mehta; Orestes E Solis; Reza Jahan; Noriko Salamon; Jonathan M Tobis; William H Yong; Harry V Vinters; Michael C Fishbein
• Keywords: Adult; Male; Cerebrovascular; Polymers; pulmonary infarct; Clinical Sciences; Embolism; 610; Bioengineering; hydrophilic polymer; Clinical sciences; Medical and Health Sciences; Catheterization; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Ischemia; Cardiovascular Medicine and Haematology; 616; 80 and over; Pathology; Humans; cerebral infarct; Aged; Aged, 80 and over; Assistive Technology; Biomedical and Clinical Sciences; guidewire; catheter; Middle Aged; Foreign Bodies; Brain Disorders; 3. Good health; Stroke; interventional procedure; Infarction; Female; Patient Safety; Gels

With the increased use of percutaneous intravascular diagnostic and therapeutic devices, there is potential for embolization materials introduced into vasculature. We report nine cases foreign body emboli in patients who underwent vascular procedures using hydrophilic-coated medical devices. The performed included cardiac catheterization (four cases), cerebral angiography (two with coil intracerebral aneurysm (one case), lower extremity and/or orthotopic cadaveric organ transplantation (three cases). Other these hemodialysis peripheral arterial or central venous catheterization. Clinical sequelae ranged from undetectable (no symptoms) to pulmonary infarction, stroke, ongoing gangrene, death occurring within days weeks suspected material. Microscopic findings biopsy autopsy tissue revealed aggregates amorphous lamellated, non-refractile, non-polarizable, predominantly basophilic substances occluding intrapulmonary, intracerebral, arteries. This largest series documenting polymer gel materials. Polymer now widely used on several devices interventional worldwide, we suspect that complications associated iatrogenic this substance are under-recognized.