The lesson from the complications of coronary arteriography

Catheter fragmentation: a potential source of catheter embolus

Aortic root angiography in the patient described in the present report was complicated by precipitious catheter occlusion. Analysis of the occluding fragment by infrared spectroscopy indicated that it was a urethane structure, suggesting that the occluding fragment resulted from spontaneous fragmentation of the polyurethane catheter. Experience with this patient thus documents the potential for nonblood catheter embolus.

Complications of coronary angiography

The new Kifa catheter decreased the rte of complications related to the nature of the catheter, enabled the examination to be performed more safely and reduced the examination time compared with the Cook catheter. The Kifa catheter for the right coronary artery could also be used for a subsequent left ventriculography.

The provocation of coronary artery spasm

On the basis of the overall experience, the provocation of coronary artery spasm with ergonovine is thought to be a highly sensitive and specific test for coronary artery spasm in Prinzmetal's variant angina. In spite of occasional complications, in experienced hands the procedure is considered to be safe. The challenge remains to determine the value of this and other provocative interventions in assessing the role of spasm in other aspects of ischemic heart disease, particularly in patients with critical atherosclerotic lesions.