Iatrogenic air embolism

• Verfasst von: Schaefer, Tabea [VerfasserIn]
• Verfasst von: Greive, Svenja [VerfasserIn]
• Verfasst von: Bierwisch, Claas [VerfasserIn]
• Verfasst von: Mohseni-Mofidi, Shoya [VerfasserIn]
• Verfasst von: Heiland, Sabine [VerfasserIn]
• Verfasst von: Kramer, Martin [VerfasserIn]
• Verfasst von: Möhlenbruch, Markus Alfred [VerfasserIn]
• Verfasst von: Bendszus, Martin [VerfasserIn]
• Verfasst von: Vollherbst, Dominik [VerfasserIn]
• Titel: Iatrogenic air embolism
• Titelzusatz: influence of air bubble size on cerebral infarctions in an experimental in vivo and numerical simulation model
• Verf.angabe: Tabea C. Schaefer, Svenja Greive, Claas Bierwisch, Shoya Mohseni-Mofidi, Sabine Heiland, Martin Kramer, Markus A. Möhlenbruch, Martin Bendszus, Dominik F. Vollherbst
• Jahr: 2023
• Umfang: 6 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 03.06.2024
• Titel Quelle: Enthalten in: Journal of neuroInterventional surgery
• Ort Quelle: London : BMJ Journals, 2009
• Jahr Quelle: 2024
• Band/Heft Quelle: 16(2024), 10, Seite 1036-1041
• ISSN Quelle: 1759-8486
• DOI: doi:10.1136/jnis-2023-020739
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Angiography
• Sach-SW: Catheter
• Sach-SW: Complication
• Sach-SW: Intervention
• Sach-SW: Stroke
• K10plus-PPN: 1890507687
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

Background Cerebral infarctions resulting from iatrogenic air embolism (AE), mainly caused by small air bubbles, are a well-known and often overlooked event in endovascular interventions. Despite their significance, the underlying pathophysiology remains largely unclear. - Methods In 24 rats, AEs were induced using a microcatheter, positioned in the carotid artery via femoral access. Rats were divided into two study groups, based on the size of the bubbles (85 and 120 µm) and two sub-groups, differing in air volume (0.39 and 0.64 µl). Ultra-high-field magnetic resonance imaging (MRI) was performed 1.5 hours after intervention. MRI findings including the number, single volume and total volume of the infarctions were assessed. A software-based numerical simulation was performed to qualitatively assess the microvascular pathomechanisms. - Results In the study groups 22 of 24 rats (92%) revealed cerebral infarctions. The number of infarctions per rat was higher for the smaller bubbles, for the lower (medians: 5 vs 3; p=0.049) and higher air volume sub-groups (medians: 6 vs 4; p=0.012). Correspondingly, total infarction volume was higher for the smaller bubbles (1.67 vs 0.5 mm³; p=0.042). Simulations confirmed the results of the experiments and suggested that fusion of microbubbles to larger bubbles is the underlying pathomechanism of vascular occlusions. - Conclusion In iatrogenic AE, the size of the bubbles can have a major impact on the number and total volume of cerebral infarctions. These findings can help to better understand the pathophysiology of this frequent, often underestimated adverse event in endovascular interventions.