The role of catheters and guidewires in the production of angiographic thromboembolic complications.

Thromboembolic complications occurring during angiography may result from a number of different causes. Catheters and guidewires can interact with blood to form thrombi; this tendency is related to wall defects and the chemical composition and structural characteristics of the catheters and guidewires. Nonthrombic sources of emboli may consist of foreign bodies derived from surgical equipment or may exist in the flushing solution and contrast media. Plastic emboli may be shed from catheters and guidewires when the guidewires are passed through the catheters. Air emboli may result from poor technique or loose fitting connections between the catheter and injector or syringe; they can mimic emboli from catheters and guidewires. A number of strategies for decreasing the risk of thromboembolic complications during angiography are reviewed.