Case report: Artery of Percheron infarction as a rare complication during atrial fibrillation ablation

• Published in: Frontiers in cardiovascular medicine Vol. 9
• Main Authors: Xie, Xin, Wang, Xuecheng, Yu, Jinbo, Zhou, Xiaoqian, Shi, Liya, Zhou, Jian, Wu, Yizhang, Chen, Zijun, Zhang, Baowei, Li, Xiaorong, Yang, Bing
• Format: Journal Article
• Language: English
• Published: Frontiers Media S.A 13.09.2022
• Subjects: artery of Percheron; atrial fibrillation; Cardiovascular Medicine; catheter ablation; complication; stroke
• ISSN: 2297-055X; 2297-055X
• DOI: 10.3389/fcvm.2022.914123

The incidence of stroke or transient ischemic attacks (TIA) in atrial fibrillation (AF) catheter ablation procedures is around 1% and may be unnoted under anesthesia. The artery of Percheron (AOP) infarction is a rare kind of stroke with heterogeneity in manifestation, which further makes the perioperative early detection and diagnosis a challenge. Herein, we present one patient who underwent AF ablation and presented mental status alteration after withdrawing anesthetics. An emergency head CT was obtained, which revealed no apparent pathological changes. A late MRI test confirmed the diagnosis of AOP infarction. With oral anticoagulants and rehabilitation therapies, the patient’s awareness improved and fully recovered on the sixth-month follow-up. Variability in manifestation, no positive radiological finding on initial CT, and a low incidence has made few clinicians to gain much experience with this type of infarct, which delays the diagnosis and initiation of appropriate treatment.