Complications of angiography.

Abstract

This study was designed to assess the complications of angiography, including transfemoral, transaxillary, and translumbar approaches. Detailed questionnaires were completed by radiologists at 514 of the 2,066 hospitals surveyed. The radiologists reported on the complications of 118,591 examinations. The overall arteriography complication rates were: transfemoral 1.73%, translumbar 2.89%, and transaxillary 3.29%. Thirty deaths were reported, eight of which were caused by aortic dissection or aneurysm rupture. Among the three techniques, there was no difference in the incidence of cardiac complications. There were significantly more neurologic complications, including seizures, in the transaxillary group than there were in either the transfemoral or translumbar groups. Similarly, hemorrhage, arterial obstruction, and pseudoaneurysms were more common with the transaxillary technique than with either of the other approaches. Vessel perforation and extraluminal contrast material were seen most frequently with the translumbar technique. Overall, between the two selective approaches, the transfemoral route carried a significantly smaller risk of complications than the transaxillary approach. There was an inverse relationship between complication rate and the annual number of arteriograms obtained. This was most striking in hospitals without residency training programs. The complications of adrenal venography, peripheral venography, pedal lymphography, and of studies for suspected pheochromocytoma were also assessed.