Arterial dissection with use of catheter needle in retrograde femoral arteriography.

A retrospective study of 82 cases of peripheral vascular occlusive disease examined by retrograde femoral arteriography with a catheter needle technique showed a 6% incidence of retrograde arterial wall dissection involving the iliac arteries and the aorta. In one patient, the dissection re-entered the abdominal aorta near the renal arteries, producing an iatrogenic chronic dissection. The others did not demonstrate any permanent side effects. In 1974, in view of the appreciable risk in the use of a catheter needle, the technique was changed to percutaneous femoral catheterization of the abdominal aorta using a catheter with multiple side holes. No further cases of iatrogenic aortic dissection were observed. A veriety of mechanisms may have been responsible for the dissections.