Complication rate of coronary arteriography. A review of 5250 cases studied by a percutaneous femoral technique.

Bourassa, Martial G.; Noble, Jacques

doi:10.1161/01.cir.53.1.106

Cited by 212 publications

(35 citation statements)

References 30 publications

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“…The adjusted ratio of the percentage of brachial to 6. The difference in mortality rates for the brachial and femoral procedures in clinics that performed 1-43% brachial procedures is statistically significant (p < 0.0002), while there was no difference in mortality for the two techniques in clinics which used 80% or more brachial procedures.…”

Section: Description Of Study Populationmentioning

confidence: 88%

Complications of coronary arteriography from the Collaborative Study of Coronary Artery Surgery (CASS).

Davis¹,

Kennedy²,

Kemp³

et al. 1979

Circulation

347

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SUMMARY Data were collected prospectively on 7553 consecutive patients undergoing coronary arteriography. The studies were performed at 13 clinics of the Collaborative Study of Coronary Artery Surgery (CASS) using brachial and femoral techniques.There were eight deaths 0-24 hours and seven deaths 24-48 hours after arteriography (2/1000). There were 15 non-fatal myocardial infarctions (MIs) 0-24 hours and four MIs 24-48 hours after arteriography (2.5/1000). Of 657 cases with left main stenosis 50%, five died and three had MI. Left main disease increased risk of desth by 6.8 times (p < 0.001). Other factors increasing risk were unstable angina, congestive heart failure, multiple prematurs ventricular contractions, and hypertension.Of the 1187 patients studied fr;om the brachial artery, six died (0.51%) and five had MIs (0.42%). In 6328 patients studied from the femoral artery, nine died (0.14%) and 14 had MIs (0.22%). The brachial artery technique increased the risk of death 3.6 times compared with the femoral approach (p < 0.05). This result did not apply when analysis was yestricted to laboratories with 80% or more brachial procedures. Risk was not altered by heparin. I'hus, a prospective, multicenter analysis of complications reveals low risk of coronary arteriography but significant difference between two techniques. SELECTIVE CORONARY ARTERIOGRAPHY is a commonly performed diagnostic procedure. A comprehensive understanding of the risk of selective coronary arteriography requires a prospective, multiinstitutional evaluation of consecutive patients undergoing this procedure. Evaluation of the factors which increase the risk of arteriography necessitates knowledge of the clinical and laboratory findings in each patient studied.The data we report were collected prospectively on consecutive patients undergoing coronary arteriography in 13 institutions as part of the Collaborative Studies in Coronary Artery Surgery (CASS), funded by the Department of Health, Education, and Welfare through the National Institutes of Health. The paiticipating institutions include university hospitals and large and medium-sized private medical centers. Enough patients were studied by the brachial and femoral artery techniques to compare the risk associated with each approach. MethodsCASS is a large collaborative c;inical trial designed to evaluate the efficacy of coronary artery bypass surgery. Every patient who undergoes coronary arteriography for suspected coronary artery disease in one of the 15 participating clinics is a candidate for the registry and is followed at regular intervals over a 5-year period. Each patient must give informed consent before being entered into the study.

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Section: Description Of Study Populationmentioning

confidence: 88%

Complications of coronary arteriography from the Collaborative Study of Coronary Artery Surgery (CASS).

Davis¹,

Kennedy²,

Kemp³

et al. 1979

Circulation

347

View full text Add to dashboard Cite

show abstract

“…Because in this study 10% of cases were randomly selected from all PCIs, approximately 1,600 PCIs were estimated to be performed on LMT lesions and 800 PCIs on the 'unprotected LMT' during 1997 in Japan. In general, the natural history of LMT disease is poor and CABG is recommended for its treatment; [8][9][10][11][12] however, several recent studies have demonstrated that PCI can be performed safely and effectively for LMT lesions. 13,14 Although 86% of PCIs excluding AMI had evidence of myocardial ischemia, 24% only had symptoms without objective evidence of ischemia.…”

Section: Discussionmentioning

confidence: 99%

Coronary Revascularization in Japan

Shihara

Tsutsui

Tsuchihashi

et al. 2002

Circ J

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“…The transcranial Doppler technique (TCD) has been used as a noninvasive means to detect cerebral microemboli occurring during endovascular procedures like cerebral angiography, or during surgical procedures such as bypass surgery or carotid endarteriectomy [5, 6, 7, 8, 9]. However, the clinical significance and precise nature of the microembolic signals (MES) detected with TCD during catheter-based procedures such as coronary angiography and angioplasty, is currently still debated [5, 6, 10, 11, 12]. Gaseous bubbles may be introduced during the injection of contrast media or saline [5, 6, 12].…”

Section: Introductionmentioning

confidence: 99%

“…However, the clinical significance and precise nature of the microembolic signals (MES) detected with TCD during catheter-based procedures such as coronary angiography and angioplasty, is currently still debated [5, 6, 10, 11, 12]. Gaseous bubbles may be introduced during the injection of contrast media or saline [5, 6, 12]. Solid embolic material may result from atheromatous plaque dislodgment, occurring during the progression of catheters through the aorta, or may be the consequence of clotting phenomena which can occur at the surfaces of guide wires and catheters [13].…”

Section: Introductionmentioning

confidence: 99%

Transcranial Doppler Detection of Cerebral Microemboli during Left Heart Catheterization

Leclercq

Kassnasrallah

et al. 2001

Cerebrovasc Dis

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The role of transcranial Doppler ultrasonography (TCD) in individual risk assessment of embolic complications and the development of prevention strategies during coronary angiography remains to be determined. The purpose of this study was to assess the prevalence, time of occurrence and potential significance of microembolic signals (MES) detected with TCD during femoral left heart catheterization. TCD monitoring of the right and left middle cerebral artery was performed in 51 consecutive patients (36 men, 15 women) who were referred for coronary angiography. Percutaneous coronary angioplasty was performed during the same procedure in 16 patients. MES were counted manually during and after (off-line analysis) the procedure. Two patients were excluded from analysis because of the absence of an adequate acoustic temporal window. No neurological event occurred within 24 h in the 49 included patients. MES were detected in all except 2 patients (mean number 17.1 ± 12.8 per patient), mainly during left ventriculography (38%) and contrast media injection into the coronary arteries (55%), suggesting their gaseous origin. There was no statistically significant association between the number of MES and patient age, cardiovascular history and risk factors, or catheterization results. The presence of coronary artery disease was inversely related to the number of MES (15.8 ± 0.3 compared to 21.8 ± 0.2 per patient when a normal angiogram was present; p < 0.05). In conclusion, although asymptomatic microemboli commonly occur during left heart catheterization, the majority of them are probably of gaseous origin, since they occurred predominantly during contrast media injection in this study, and were not related to cardiovascular history or to atheroma risk factors. Because air embolism has been reported to be harmful, attempts to reduce its occurrence during catheter-based procedures could be pertinent.

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Complication rate of coronary arteriography. A review of 5250 cases studied by a percutaneous femoral technique.

Cited by 212 publications

References 30 publications

Complications of coronary arteriography from the Collaborative Study of Coronary Artery Surgery (CASS).

Complications of coronary arteriography from the Collaborative Study of Coronary Artery Surgery (CASS).

Coronary Revascularization in Japan

Transcranial Doppler Detection of Cerebral Microemboli during Left Heart Catheterization

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