Characteristics of cerebrovascular accidents after percutaneous coronary interventions.

Abstract Objectives We sought to identify the incidence, predictors, and clinical implications of cerebrovascular accidents (CVAs) after percutaneous coronary interventions (PCIs). Background Cerebrovascular accidents after PCI, although rare, can be devastating. Limited information exists regarding the characterization of this complication. Methods The study population comprised 20,679 patients who underwent PCI between September 1993 and April 2002. A CVA was defined as a composite of transient ischemic attack (TIA) and stroke. The characteristics of those who had a periprocedural CVA were compared with those who did not. Results A CVA occurred in 92 patients (0.30% of procedures). Of these, TIA occurred in 13 patients (0.04%) and stroke in 79 patients (0.25%). On multivariate analysis, patients with this complication more frequently had diabetes mellitus (adjusted odds ratio [OR] 1.8, 95% confidence interval [CI] 1.1 to 3.0; p = 0.013), hypertension (OR 1.9, 95% CI 1.1 to 3.3; p = 0.033), previous CVA (OR 2.3, 95% CI 1.3 to 4.0; p = 0.0059), and creatinine clearance ≤40 ml/min (OR 3.1, 95% CI 1.8 to 5.2; p Conclusions Cerebrovascular accidents after PCI, although rare, are associated with high rates of in-hospital death and acute renal failure, often requiring dialysis.