Complications of coronary arteriography

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The complications associated with selective coronary arteriography have been of continuing concern since this technique was developed 20 years ago. Many of the problems associated with selective coronary artiography during its developmental phase have now been greatly reduced or eliminated with improved catheters, contrast agents, radiographic and hemodynamic monitoring equipment and techniques in the management of the unstable cardiac patient. The large difference in complications associated with Sones's and Judkins's techniques of selective coronary arteriography reported in the early 1970s has been resolved. In this brief report, I will present what I believe to be a fair estimate of the complications of selective coronary arteriography as it is now done in large institutional laboratories in the United States. The data summarized below come from the files of the Collaborative Study of Coronary Artery Surgery (CASS) and have been recently published.1 The data were collected prospectively on 7553 consecutive patients who underwent coronary arteriography between August 1975 and December 1976. The studies were performed at 13 clinics of CASS with either Sones's or Judkins's technique. In Table 1, some of the characteristics of the patient population are listed. Since CASS sites register each patient undergoing selective coronary arteriography for suspected coronary artery disease, the population characteristics are probably similar to those of many diagnostic laboratories.

There were eight deaths 0 to 24 hours and seven deaths 24 to 48 hours after arteriography (2/1000). There were 15 nonfatal myocardial infarctions 0 to 24 hours and four myocardial infarctions 24 to 48 hours . . .



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