PULMONARY ANGIOGRAPHY - A SAFE PROCEDURE WITH MODERN CONTRAST-MEDIA AND TECHNIQUE

Pulmonary angiography (PA) for decades has been accepted as the gold s tandard for the diagnosis of pulmonary embolism (PE). Apprehensions th at the procedure is expensive, invasive and thus associated with both fatal and non-fatal complications has more or less limited its use to patients Presenting a non-diagnostic lung scan. However, this opinion originates from earlier-studies. Increasing clinical demands for faste r and safer diagnostics, together with improved techniques and safer c ontrast media, has led to an increased use of PA. In order to evaluate the complication rate, we retrospectively studied the case records of 707 consecutive patients who had undergone PA. During 1940-1994, 728 patients underwent PA at Danderyd End Huddinge University Hospital. Se lective pulmonary angiography (cine or digital subtraction angiography ), non-ionic, low-osmolar contrast media and modern pigtail catheters' were used. Standard volumes were 40 ml at 2 s for each injection. Pre ssure measurements were made in 376 patients. A test injection was mad e in all patients in order to assess the flow rate. Experienced radiol ogists as well as residents performed the examinations and a total of 707 angiography protocols and clinical records were available for revi ew in search of complications associated with the procedure. No deaths occurred. One major non-fatal complication (bleeding in the groin req uiring surgery) was reported in one case. Moderate/minor complications (i.e. transient cardiac failure, minor haematomas, urticaria and occu rred in 10 patients (1.4%). With modern contrast media and technique, pulmonary angiography is a safe procedure.