Complication Rates of Diagnostic Angiography Performed by Vascular Surgeons

Abstract

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.

Complications of Diagnostic Arteriography Performed by a Vascular Surgeon in a Recent Series of 558 Patients

“…5 The overall major complication rate in our present series was statistically significantly superior to what was published in our past series in 1993, 3 which included complications performed by our radiologists at our institution during that time period (p , .001).…”

Diagnosis and management of atherosclerotic renal artery stenosis: improving patient selection and outcomes

“…The incidence of major complications associated with peripheral vascular angiography ranges from 1.9% to 2.9% (Table 3). 99 Atheroembolism, vessel dissection, and arterial perforation caused by catheterization of the renal artery are rare (<1%), but often devastating, events. Anaphylactic reactions to contrast media occur in less than 3% of patients, and less than 1% require hospitalization.…”

Current Approach to the Diagnosis and Treatment of Femoral-Popliteal Arterial Disease. A Systematic Review

“…Angiography carries the inherent risks associated with any invasive procedure, including those related to vascular access (e.g. bleeding, infection, atheroembolism, dissection, vessel disruption or perforation, hematoma, pseudoaneurysm, arteriovenous fistula) with rates of major complications ranging from 1.9 to 2.9%, which is further reduced with operator experience [35]. Anaphylactoid reactions occur in fewer than 3% of cases with the risk of severe reactions of approximately 0.1% [36].…”