An unusual complication following percutaneous coronary intervention: Contrast-induced encephalopathy

Abstract

Contrast-induced encephalopathy (CIE) represents an infrequent adverse event linked to angiographic procedures. The clinical presentation encompasses various focal neurological impairments, notably encephalopathy, seizure activity, ophthalmoplegia, and cortical blindness. We hereby detail the clinical course of a 43-year-old man who developed CIE subsequent to a successful revascularization procedure for a Left Anterior Descending Artery Chronic Total Occlusion (LAD-CTO). The elective coronary intervention was finalized with the administration of 300 ml of iohexol. Post-procedurally, the patient suffered a convulsion and was immediately admitted to the Intensive Care Unit. Following the onset of cortical blindness, appropriate central nervous system imaging was conducted to eliminate the possibility of hemorrhagic or ischemic events, initiating hydration as the primary management strategy. The patient achieved a full recovery of his visual function within 18 hours of treatment commencement. In summary, CIE is an exceptionally rare yet recognized complication of both diagnostic angiography and percutaneous interventions. Clinicians must maintain a heightened index of suspicion for this condition during the evaluation of acute post-procedural neurological changes.