Complications of selective percutaneous transfemoral coronary arteriography

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Surgery

Background:

• Selective coronary arteriography is a key diagnostic tool.
• The percutaneous transfemoral approach is commonly used.
• Minimizing procedural complications is crucial for patient safety.

Purpose of the Study:

• To evaluate the safety and complication rates of selective coronary arteriography.
• To identify potential improvements in procedural technique.
• To assess the impact of specific modifications on complication incidence.

Main Methods:

• A total of 1,250 selective coronary arteriographic procedures were analyzed.
• The percutaneous transfemoral technique was consistently employed.
• Procedural modifications included routine use of a transparent manifold and specific guide wire removal.

Main Results:

• No deaths occurred during the 1,250 procedures.
• Local complications included hemorrhage (14), peripheral emboli (2), and thrombosis (1).
• Cerebral complications occurred in 4 patients (emboli, thrombus dislodgement).
• Cardiac complications included ventricular fibrillation (11), myocardial infarction (3), and hypotension (1).
• No cerebral emboli or myocardial infarctions were observed in the final 500 procedures after implementing technical changes.

Conclusions:

• The percutaneous transfemoral approach for selective coronary arteriography demonstrates a low mortality rate.
• Specific technical modifications, such as using a transparent manifold and altering guide wire management, can significantly reduce serious complications like cerebral emboli and myocardial infarction.
• These findings support the adoption of refined techniques to enhance patient safety during coronary arteriography.