Aortoiliac angiography during coronary artery angiography detects significant occult aortoiliac and renal artery atherosclerosis in patients with coronary atherosclerosis.
OBJECTIVE
Peripheral atherosclerosis (renal and aortoiliac localizations) are frequently detected in aged patients with concomitant coronary artery disease (CAD): the risk of finding peripheral disease is increased in patients with CAD. Angiography of the aortoiliac vessels performed at the time of coronary angiography may detect any occult renal artery stenosis and atherosclerotic involvement of the aortoiliac segment. We sought to determine utility of performing angiography of aortoiliac and renal arteries during coronary arteriography in patients with known or suspect coronary atherosclerosis.


METHODS
Medical records of all patients undergoing combined coronary and aortoiliac angiography between May 1998 and December 2002 was retrospectively reviewed. Moderate to severe arterial stenosis (>50% stenosis), vessel occlusion, aneurismal vessels were noted as significant angiographic findings. Contrast-induced nephropathy was defined as a rise in serum creatinine of > or =25% form baseline.


RESULTS
In the study period 112 patients (81 males, mean age 68.4+/-7.8 years) with known or suspected CAD underwent combined cardiac catheterization and aortoiliac angiography. Pretreatment with 0.45% saline at a rate of 1 ml/kg/h for 12 h was administered to all patients. Significant findings were reported in 37 (33%) patients including 14 renal artery stenoses, 8 aortic aneurismal disease, and 15 aortoiliac lesions. Most patients with significant findings had 2 and 3-vessel CAD. A strong correlation was found between the number of risk factors and the frequency of angiographic findings (r = 0.92). Complications include six contrast-induced nephropathy: no case required renal replacement therapy.


CONCLUSIONS
Aortoiliac and renal atherosclerosis is frequently associated to multivessel CAD. In selected patients undergoing cardiac catheterization aortoiliac angiography may be practical in detecting occult renal or aortoiliac artery lesions. Further clinical outcome studies are strongly required to support this strategy.
Rigatelli
Gianluca
G
Endo Cardio Vascular Therapy Research, via T Speri 18, 37040 Legnago, Verona, Italy. jackyheart@hotmail.com
D000368:Aged; D017130:Angioplasty; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D019917:Blood Vessel Prosthesis Implantation; D006328:Cardiac Catheterization; D003287:Contrast Media / Q000009:adverse effects; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging* / Q000473:pathology*; D007674:Kidney Diseases / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D012189:Retrospective Studies; D013223:Statistics as Topic; D015607:Stents; D016896:Treatment Outcome
D003287:Contrast Media