Radiology, Vol 175, 71-74, Copyright © 1990 by Radiological Society of North America
Rapid progression of peripheral vascular disease after diagnostic angiography
BD Fellmeth, JJ Bookstein, AL Lurie and JP Dillard
Department of Radiology, University of California, San Diego Medical Center 92103.
The authors retrospectively reviewed records of percutaneous transluminal
angioplasties performed at three institutions. Seven stenotic lesions in
peripheral vessels were identified that had progressed to total occlusion
in the interval between the time that diagnostic run-off angiography and
attempted angioplasty were performed. The post-angiographic occlusions were
3-16 cm long (mean, 9 cm), and the interval between diagnostic angiography
and discovery of the occlusions ranged from 1 hour to 91 days (median, 2
days). Treatment of the occlusions was riskier and more difficult than
simple angioplasty of the original stenoses. The authors conclude that some
aspect of the angiographic procedure probably precipitated the transition
from stenosis to occlusion. This complication can be prevented by
preparation for angioplasty immediately after diagnostic run-off
angiography or perhaps by use of heparin during the diagnostic study.
