angiographic embolization
The migration of atherothrombotic material to distal coronary vessels during intervention, visible as filling defects or abrupt vessel cutoff on angiography.
Full Definition
Angiographic embolization refers to the distal migration of thrombotic or atherosclerotic debris during percutaneous coronary intervention, creating visible angiographic evidence of vessel occlusion or filling defects in previously normal distal vessels. This complication can result from balloon inflation, stent deployment, or aggressive lesion manipulation, particularly in lesions with high thrombus burden or friable plaque. Embolization manifests as new filling defects, abrupt vessel cutoff, or deterioration in TIMI flow grade in previously normal vessels. The phenomenon is associated with impaired myocardial reperfusion, increased infarct size, and worse clinical outcomes. Management may include aspiration thrombectomy, GP IIb/IIIa inhibitors, or embolic protection devices in appropriate settings.
Usage
Usage note: Document the timing of embolization relative to intervention steps and specify affected vessel territories.
In Context
- "Angiographic embolization was observed in the distal LAD following balloon pre-dilatation, requiring GP IIb/IIIa inhibitor administration." — Procedural complication report
- "Post-stent deployment angiography revealed no evidence of angiographic embolization with preserved TIMI 3 flow distally." — Intervention completion note