Age Related Complications of Pulmonary Angiography for Acute Pulmonary Embolism

The relation of age to complications of pulmonary angiography was assessed among 1111 patients who underwent pulmonary angiography for acute pulmonary embolism in the collaborative study of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED). The quality of pulmonary angiograms was similar among all age groups in the study. Neither major nor nonmajor complications occurred with a greater total frequency among elderly patients than among young patients. Manor and nonmajor renal failure, however, were more frequent among patients 70 years of age or older, and this was the most frequent complication of angiography in this age group. Among patients 70 years of age and older, renal failure occurred in 7 of 281 (2.5%), as opposed to 6 of 830 (0.7%) patients 69 years old or younger (P is less than 0.05). Patients with either major or nonmajor renal complications were older than patients with no renal dysfunction following pulmonary angiography (74Â+/-13 yr vs 57Â+/-17 yr) (P is less than 0.001). Most of the patients who died or sustained major nonfatal cardiopulmonary complications, irrespective of age, were in critical condition with severely compromised cardiopulmonary function prior to angiography; the severity of the underlying condition rendered these patients vulnerable to the procedure. In conclusion, high-quality pulmonary angiography can be done safely on elderly patients. The risks of pulmonary angiography are sufficiently low to justify it as a diagnostic tool in the appropriate clinical setting, even in elderly patients. Clinical judgment is important in selecting patients and assessing their risk.