Adams D F, Abrams H L
Cardiovasc Radiol. 1979 Apr 27;2(2):89-96. doi: 10.1007/BF02575368.
A nationwide survey of complications due to coronary arteriography during 1973--74 yielded responses from 176 hospitals (89,079 coronary arteriograms). The overall mortality rate was 0.14% (brachial, 0.12%; femoral, 0.16%). In the brachial group, the mortality rate was three times as high for non-heparinized as for heparinized patients. In institutions performing fewer than 100 examinations per year, the combined incidence of death, myocardial infarction, and cerebral embolism was five times higher than in institutions performing more than 400 examinations per year. Left main coronary artery or three-vessel disease was present in most patients who died of the procedure. Compared to a previous survey of 1970--71, there was a profound decrease in significant complications (including death, myocardial infarction, and cerebral embolism) and entry site complications such as thrombosis. A reduction in mortality with the femoral technique since 1971 was not accounted for by heparinization and may reflect increasing experience with the method and shorter angiographic times.
