Complications of angiography.

Abstract

The complications of angiography, including transfemoral, transaxillary and translumbar approaches, were assessed. Detailed questionnaires were completed by radiologists at 514 of the 2066 hospitals surveyed. The radiologists reported on the complications of 118,591 examinations of patients. The overall arteriography complication rates were: transfemoral 1.73%, translumbar 2.89% and transaxillary 3.29%. Thirty deaths were reported, 8 of which were caused by aortic dissection or aneurysm rupture. Among the 3 techniques, there was no difference in the incidence of cardiac complications. There were significantly more neurologic complications, including seizures, in the transaxillary group than in either the transfemoral or translumbar groups. 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. Between the 2 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 assessed.