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Summary
The transfemoral approach for angiography has a lower complication rate than transaxillary or translumbar methods. Higher annual angiography volume correlates with fewer complications, especially in non-training hospitals.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Diagnostic Imaging
Background:
- Angiography is a crucial diagnostic tool.
- Different approaches carry varying risks.
- Assessing complication rates is vital for patient safety.
Purpose of the Study:
- To evaluate and compare the complication rates of transfemoral, transaxillary, and translumbar angiography.
- To identify factors influencing complication incidence.
Main Methods:
- A survey of 514 hospitals reporting on 118,591 angiography examinations.
- Data collected via detailed questionnaires completed by radiologists.
- Analysis of complication types and rates across different approaches.
Main Results:
- Overall complication rates: transfemoral (1.73%), translumbar (2.89%), transaxillary (3.29%).
- Transaxillary approach showed higher rates of neurologic complications, hemorrhage, obstruction, and pseudoaneurysms.
- Translumbar approach had more vessel perforations and extraluminal contrast.
- No significant difference in cardiac complications between groups.
Conclusions:
- The transfemoral approach is associated with a lower risk of complications compared to the transaxillary approach.
- Higher annual procedural volume inversely correlates with complication rates.
- Hospitals without residency programs showed a more pronounced inverse relationship between volume and complications.