Related Experiment Videos
Complications of coronary arteriography: a follow-up report
Insights
Coronary arteriography complications decreased significantly between 1970-71 and 1973-74, with lower mortality rates. Higher volume centers and heparin use in brachial procedures improved patient safety.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Imaging
Background:
- Coronary arteriography is a crucial diagnostic procedure.
- Assessing procedural complications is vital for patient safety.
- Previous data highlighted risks associated with coronary arteriography.
Purpose of the Study:
- To evaluate complications and mortality rates of coronary arteriography.
- To identify factors influencing procedural safety.
- To compare current complication rates with previous surveys.
Main Methods:
- Nationwide survey of 176 hospitals.
- Analysis of 89,079 coronary arteriograms from 1973-74.
- Comparison of data with a 1970-71 survey.
Main Results:
- Overall mortality rate was 0.14%.
- Brachial approach mortality was higher in non-heparinized patients.
- High-volume institutions had significantly lower complication rates.
- Significant decrease in major complications and entry site issues compared to 1970-71.
- Femoral technique mortality reduction may be linked to increased experience.
Conclusions:
- Coronary arteriography safety has improved.
- Heparinization and institutional experience are key factors in reducing complications.
- The femoral approach shows a promising trend in safety.
Abstract:
A nationwide survey of complications due to coronary arteriography during 1973--74 yielded responses from 176 hospitals (89,079 coronary arteriograms). The overall mortality rate was 0.14% (brachial, 0.12%; femoral, 0.16%). In the brachial group, the mortality rate was three times as high for non-heparinized as for heparinized patients. In institutions performing fewer than 100 examinations per year, the combined incidence of death, myocardial infarction, and cerebral embolism was five times higher than in institutions performing more than 400 examinations per year. Left main coronary artery or three-vessel disease was present in most patients who died of the procedure. Compared to a previous survey of 1970--71, there was a profound decrease in significant complications (including death, myocardial infarction, and cerebral embolism) and entry site complications such as thrombosis. A reduction in mortality with the femoral technique since 1971 was not accounted for by heparinization and may reflect increasing experience with the method and shorter angiographic times.