Complication rates of diagnostic angiography performed by vascular surgeons

The objective of this study was to compare the complication rates of diagnostic angiography performed by vascular surgeons to those previously published by interventional radiologists. From May 1999 through August 2000, 3 board-certified vascular surgeons performed 224 endovascular procedures in a modern endovascular suite. Of these 224 procedures, 144 were diagnostic angiographies. A retrospective chart review was conducted to identify periprocedural complications of these angiographies. The patients were classified into 3 groups according to the indication for angiography, and the major and overall complication rates were tabulated. The complication rates for the initial 25 and subsequent 119 arteriographies were compared to evaluate the presence of a learning curve. Thirty-eight percent of angiographies were performed to define aneurysmal anatomy (type I), 51% to define peripheral arterial stenosis or occlusion (type II), and 12% to assess symptomatic carotid artery disease or mesenteric ischemia (type III). The major complication rates for these 3 types were 0%, 2.7%, and 5.9%, respectively, and showed no statistical difference (Fischer's exact test) compared to published rates of 0.7%, 2.9%, and 9.1%. Major complications included an external iliac artery dissection, a cerebral air embolus, and a deep venous thrombosis. The overall major complication rate was 2.1%, which compares to published rates of 1.9-2.9%. The major complication rates for the initial 25 and final 119 were 8% and 0.8%, respectively. Vascular surgeons can perform diagnostic angiography with acceptable complication rates. The complication rate is reduced with angiographic experience.