[Reserve concerning pulmonary angiography in pulmonary embolism is not justified]

Evaluation of the safety of pulmonary angiography in patients with clinically suspected pulmonary embolism.

Retrospective cohort study.

Academic Hospital, Rotterdam, the Netherlands.

The data on complications of pulmonary angiography were collected from four Dutch hospitals over a period of about five years (Academic Medical Centre and Slotervaart Hospital, Amsterdam; St. Elisabeth Hospital, Tilburg and Dr. Daniel den Hoed Cancer Centre/University Hospital Rotterdam).

Pulmonary angiography was performed in 697 patients. No fatal complications were noted (mortality: 0%; 95% confidence interval (95% CI); 0.00-0.53). Complications were seen in 3 patients; dissection of the pulmonary artery in I patient and contrast extravasation in 2 patients (morbidity: 0.4%; 95% CI: 0.09-1.25).

In patients with clinically suspected pulmonary embolism, pulmonary angiography is a safe diagnostic modality. It is recommended that, in patients in whom the diagnosis of pulmonary embolism cannot be confirmed or excluded by noninvasive diagnostic methods, pulmonary angiography should be performed (according to the Dutch consensus "Diagnostic pulmonary embolism').