Circulation, Vol 59, 1105-1112, Copyright © 1979 by American Heart Association
K Davis, JW Kennedy, HG Kemp Jr, MP Judkins, AJ Gosselin and T Killip
Data were collected prospectively on 7553 consecutive patients undergoing
coronary arteriography. The studies were performed at 13 clinics of the
Collaborative Study of Coronary Artery Surgery (CASS) using brachial and
femoral techniques. There were eight deaths 0--24 hours and seven deaths
24--48 hours after arteriography (2/1000). There were 15 non-fatal
myocardial infarctions (MIs) 0--24 hours and four MIs 24--48 hours after
arteriography (2.5/1000). Of 657 cases with left main stenosis greater than
or equal to 50%, five died and three had MI. Left main disease increased
risk of death by 6.8 times (p less than 0.001). Other factors increasing
risk were unstable angina, congestive heart failure, multiple premature
ventricular contractions, and hypertension. Of the 1187 patients studied
from the brachial artery, six died (0.51%) and five had MIs (0.42%). In
6328 patients studied from the femoral artery, nine died (0.14%) and 14 had
MIs (0.22%). The brachial artery technique increased the risk of death 3.6
times compared with the femoral approach (p less than 0.05). This result
did not apply when analysis was restricted to laboratories with 80% or more
brachial procedures. Risk was not altered by heparin. Thus, a prospective,
multicenter analysis of complications reveals low risk of coronary
arteriography but significant difference between two techniques.
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Complications of coronary arteriography from the Collaborative Study of Coronary Artery Surgery (CASS)
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