Thromboembolism following Coronary Arteriography

¹ Associate, Pasadena Carcdiovascimlar Research Foundation
² Assistant Clinical Professor of Pathology, University of Southern California School of Medicine; Associate Pathologist, Huntington Memorial Hospital
³ Clinical Professor of Medicine, University of Southern California School of Medicine; Director, Pasadena Cardiovascular Research Foundation

Incomplete data exist concerning complications of coronary arteriography. Specific characteristics of the angiographic dye or its rate of injection have been considered factors in the serious complications. Little attention has been directed to the problem of thromboembolism. Four cases of fatal thromboembolism are documented in this report. In each case coronary arteriography was performed in the face of severe coronary artery disease. In each case, mild shock or embolization was noted during or immediately after the procedure. Of the four deaths, fresh thrombi were present in one of the main coronary arteries in three, and in a major cerebral vessel in the fourth. Prior recognized mechanical complications of coronary arteriography, wedging and subintimal dissection, were insufficient to explain the occlusions. Factors affecting thrombogenesis, such as catheter stiffness, material, and coating, and the technical details of coronary arteriography are reviewed, and means of diminishing complications enumerated.