Angiography/PCI Complications

• Vascular: minimize risk of these by applying pressure (hand or mechanical) or using closure device following the procedure
  • It is important to inspect the patient's groin pre-procedure in order to assess for any pre-existing bruits or abnormalities
  • Hematoma: not uncommon, but can compress femoral nerve
    • Retroperitoneal extension: increased risk with arterial puncture above inguinal ligament
      • Dx with CT or abdominal ultrasound
      • Typically self-tamponade, but can require IR or vascular surgical intervention
  • AV fistula: results in femoral bruit/thrill
    • Requires surgical repair
  • Pseudoaneurysm: secondary to puncture of vessel wall, resulting in transmural hematoma contained by surrounding tissue
    • Dx with ultrasound
    • Typically resolve with pressure, but may require thrombin or collagen injection
• Ventricular perforation: first signs are often bradycardia and hypotension from increased vagal tone
  • Can progress to tamponade
• Contrast-induced nephropathy
• Stroke: from disruption of atherosclerotic plaque
• Dissection of aorta or coronary arteries

(Christopher Woo MD, 9/3/10)