Abstract Percutaneous aortography and selective arteriography by the Seldinger technique has become a widely accepted diagnostic procedure. Like any other catheterization technique, percutaneous introduction of a catheter into the lumen of an artery may be accompanied by possible complications.1-13 The most common serious complication is arterial thrombosis,4,6,8-12 usually occurring at the site of the arterial puncture. Intimal injuries are without sequelae in most instances2,3,6 and rarely require surgical intervention.8,13 A patient with a dissection of the aortic bifurcation and complete obstruction of the left common iliac artery following percutaneous catheterization from the right femoral artery is presented as an unusual, previously unreported, complication of this technique. Report of a Case A 48-year-old Negro man was admitted to the hospital on June 30, 1969, for evaluation because of repeated episodes of hematuria following sexual intercourse. Except for several years' history of elevated blood pressure, his medical history was References 1. Belan A, Kocandrle V, Pospichal J, et al: Komplikationen bei verschiedenen arteriographischen Untersuchungsmethoden . Fortschr Roentgenstr 110:57-64, 1969.Crossref 2. Gillanders LA: Aortic dissection during translumbar aortography . Brit J Radiol 36:725-728, 1963.Crossref 3. Gudbjerg CE, Christensen J: Dissection of the aortic wall in retrograde lumbar aortography . Acta Radiol 55:364-368, 1961.Crossref 4. Halpern M: Percutaneous transfemoral arteriography: An analysis of the complications in 1,000 consecutive cases . Amer J Roentgen 92:918-934, 1964. 5. Hurwitt ES, Seidenberg B: The non-operative management of two cases of catheter perforation of the aorta . Amer J Surg 110:452-455, 1965.Crossref 6. Lang EK: A survey of the complications of percutaneous retrograde arteriography: Seldinger technique . Radiology 81:257-263, 1963.Crossref 7. Lang EK: Prevention and treatment of complications following arteriography . Radiology 88:950-958, 1967.Crossref 8. McGraw JY: Arteriography of peripheral vessels: A review with report of complications . Angiology 14:306-318, 1963.Crossref 9. Mortensen JD: Clinical sequelae from arterial needle puncture, cannulation and incision . Circulation 35:1118-1123, 1967.Crossref 10. Ranniger K, Saldino, M: Abdominal angiography . Curr Probi Surg , 1968, pp 1-62. 11. Seidenberg B, Hurwitt ES: Retrograde femoral (Seldinger) aortography: Surgical complications in 26 cases . Ann Surg 163:221-226, 1966.Crossref 12. Siegelman SS, Caplan LH, Annes GP: Complications of catheter angiography and "pullout" angiograms . Radiology 91:251-253, 1968.Crossref 13. Templeton JY, Johnson RG, Griffith JR: Dissecting aneurysm of the thoracic aorta as a complication of catheter aortography: Successful surgical treatment . J Thorac Cardiovasc Surg 40:209-214, 1960.
Archives of Surgery – American Medical Association
Published: May 1, 1970