Complications of percutaneous transfemoral coronary arteriography.

Complications statistics in 1625 patients undergoing selective coronary angiography by Judkin's technique have been analysed for four major areas-death, myocardial infarction, cerebral vascular accidents, and femoral thrombosis. Over a six-year period, considerable decrease in the number of complications has occurred. Myocardial infarctions have decreased from 2.4% (1967-71) to 0.44% (1973), an improvement related to careful catheter flushing, guidewire insertion technique and careful pressure monitoring within the coronary arteries. Cerebral accidents have decreased from a maximum of 1.3% (1972) to none (1973). This is also related to catheter guidewire techniques, and to avoidance of entering the cerebral vessels inadvertently when crossing the aortic arch with the coronary catheter. Femoral artery thromboses have decreased from 2.7% (1967-71) to none (1973). This is due to monitoring the dorsalis pedis pulse when compressing the femoral artery and avoiding complete femoral arterial obstruction with the associated lack of flow ultimately leading to thrombosis. Death rate has remained essentially unchanged (0.3-0.6%).