Complications of peripheral arteriography: a new system to identify patients at increased risk.
OBJECTIVE
The most quoted literature on arteriographic complications is based on self-reports collected during the mid 1970s. We sought to determine whether those results remain valid despite changes in arteriographic practice and whether patient subgroups at increased risk could be identified.


METHODS
Five hundred forty-nine consecutive patients were examined after arteriography and twice over 72 hours. Patients were telephoned at least 2 weeks later to identify delayed complications. The sample was divided into two groups to allow independent validation of suspected prognostic factors.


RESULTS
The rate of major complications was 2.9% (16/549), but varied from 0.7% to 9.1% among three strata of relative risk. Rates were highest in patients studied for suspected aortic dissection, mesenteric ischemia, gastrointestinal bleeding, or symptomatic carotid artery stenosis and lowest in patients with trauma or aneurysmal disease. Patients studied for claudication or limb-threatening ischemia had intermediate risk (2.0%). Within these strata, congestive heart failure and furosemide use were the only variables independently associated with a significantly increased complication rate.


CONCLUSIONS
Previous reports have overestimated the risk of arteriography for trauma or aneurysm but substantially underestimate the risk for patients with other common conditions. Such stratified complication rates are essential to understand relative costs and benefits of arteriography and other vascular imaging modalities in specific clinical situations.
Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06520-8042, USA.
T K
TK
Egglin
P V
PV
O'Moore
A R
AR
Feinstein
A C
AC
Waltman
D058186:Acute Kidney Injury / Q000209:etiology; D000792:Angiography / Q000009:adverse effects*; D001808:Blood Vessels / Q000293:injuries; D003287:Contrast Media / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors
D003287:Contrast Media