Complications of Aortography

RECENT interest in the surgical treatment of renal hypertension has brought about the widespread use of retrograde aortography. The percutaneous transfemoral technic described by Seldinger 1 has produced improved arteriograms and is reported to be relatively free from complications. In a recent paper, Adeney and Fraser2 reported no complications from percutaneous retrograde aortography in 103 cases during a 4-year period. Others, including ourselves, have not been so fortunate. In June 1963, McGraw3 reported five major complications in 372 arteriograms done via the percutaneous transfemoral route. Complications included three acute arterial occlusions; one resulted in amputation and another was associated with an acute myocardial infarction and cardiac arrest. One cleared after 12 hours of conservative treatment. In addition, there was one false aneurysm and one penetration of the aortic wall with resultant dissection, multiple embolization, and death. Recently, Lang4 made a survey of 11,402 retrograde percutaneous aortograms and found seven deaths, 81 serious complications, and 325 minor complications. Arterial occlusion at the site of puncture was the most common serious complication.