We studied 60 consecutive patients to determine the incidence of pulmonary em bolism after transfemoral arteriography by comparing prearteriography lung perfusion scans with those obtained 1 day after arteriography. Nineteen patients (32%) demon strated new perfusion defects in the postarteriography lung scan. There was no signifi cant difference in regard to the incidence of pulmonary embolism with or without right heart catheterization. We believe that the source of emboli was from the leg vein thrombosis which was produced due to manual groin compression or compression from a sandbag and extended periods of bed rest after arteriography. Our data suggest that pulmonary embolism is a more common complication of transfemoral arteriography than previously appreciated.
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References
1.
Yasuno M., Kawamura O., Watanabe T., et al: Diagnostic value of thallium-201 myocardial imaging in pulmonary embolism. Angiology34:293, 1983
2.
Katzen BT: Interventional Diagnostic and Therapeutic Procedures. New York, Springer-Verlag Press, 1980, p 25.
3.
Gilday DL, Poulose KP, DeLand FH: Accuracy of detection of pulmonary embolism by lung scanning correlated with pulmonary angiography. Am J Roentgenol115:732, 1972.
4.
Kelly MJ, Elliot LP: The radiologic evaluation of the patient with suspected pulmonary thromboembolic disease. Med Clin North Am59:3, 1974.
5.
Moses DC, Silver TM, Bookstein JJ: The complementary roles of chest radiography, lung scanning, and selective pulmonary angiography in the diagnosis of pulmonary embolism. Circulation49:179, 1974.
6.
Bell WR, Simon TL: A comparative analysis of pulmonary perfusion scans with pulmonary angiograms . Am Heart J92:700, 1976.
7.
Crawford ES, Beall AC, Moyer JH, et al: Complications of aortography. Surg Gynecol Obstet104:129, 1957.
8.
Luke JC, McGraw JY: Complications following catheter angiography. Arch Surg86:414, 1963.
9.
Halpern M.: Percutaneous transfemoral arteriography. An analysis of the complications in 1,000 consecutive cases. Am J Roentgenol92:918, 1964.
10.
Takaro T., Hultgren HN, Littmann D., et al: An analysis of deaths occurring in association with coronary arteriography. Am Heart J86:587, 1973.
11.
Adams DF, Fraser DB, Abrams HL: The complications of coronary arteriography. Circulation48:609, 1973.
12.
Bourassa MG , Noble J.: Complication rate of coronary arteriography. A review of 5250 cases studied by a percutaneous femoral technique . Circulation53:106, 1976.
13.
Ross RS: Pulmonary complication. Circulation37 to 38: Suppl III-46, 1968.
14.
Lang EK: A survey of the complications of percutaneous retrograde arteriography . Radiology81:257, 1963.
15.
Lang EK: Prevention and treatment of complications following arteriography . Radiology88:950, 1967.
16.
Primm RK, Segall PH, Alison HW, et al: Incidence of new pulmonary perfusion defects after routine cardiac catheterization. Am J Cardiol43:529, 1979.
17.
Chastre J., Cornud F., Bouchama A., et al: Thrombosis as a complication of pulmonary-artery catheterization via the internal jugular vein. Prospective evaluation by phlebography. N Engl J Med306:278, 1982.
18.
Foote GA, Schabel SI, Hodges M.: Pulmonary complications of the flow-directed balloon-tipped catheter . N Engl J Med290:927, 1974.
19.
Goodman DJ, Rider AK, Billingham ME, et al: Thromboembolic complications with the indwelling balloon-tipped pulmonary arterial catheter. N Engl J Med291:777, 1974.
20.
Hildner JF, Ormond RS: Accuracy of the clinical diagnosis of pulmonary embolism. JAMA202:115, 1967.
Bell WR, Simon TL, DeMets DL: The clinical features of submassive and massive pulmonary embolism , Am J Med62:355, 1977.
23.
Stein PD, Willis PW III, DeMets DL: History and physical examination in acute pulmonary embolism in patients without preexisting cardiac or pulmonary disease. Am J Cardiol47:218, 1981.
24.
Israel HL, Goldstein F.: The varied clinical manifestations of pulmonary embolism. Ann Intern Med47:202, 1957.
25.
Williams JR , Wilcox WC: Pulmonary embolism. Roentgenographic and angiographic considerations. Am J Roentgenol89:333, 1963.
26.
Cugell DW, Buckingham WB, Webster JR Jr, et al: The limitations of laboratory methods in the diagnosis of pulmonary embolism. Med Clin North Am51:175, 1967.
27.
Szucs MM Jr , Brooks HL, Grossman W., et al: Diagnostic sensitivity of laboratory findings in acute pulmonary embolism. Ann Intern Med74:161, 1971.
