Diagnostic coronary angiography in patients with peripheral arterial disease: A sub-study of the coronary artery revascularization prophylaxis trial

Santiago Garcia, Edward O. McFalls, Steven Goldman, Greg C. Larsen, Fred Littooy, Thomas E. Moritz, Domenic J. Reda, Herbert B. Ward, Kendrick Shunk, Brack Hattler

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Although patients in need of elective vascular surgery are often considered candidates for diagnostic coronary angiography, the safety of this invasive study has not been systematically studied in a large cohort of patients scheduled for an elective vascular operation. The goal of this sub-study of the Coronary Artery Revascularization Prophylaxis (CARP) trial was to assess the safety of coronary angiography in patients with peripheral vascular disease. Methods: The CARP trial tested the long-term benefit of coronary artery revascularization prior to elective vascular operations. Among those patients who underwent diagnostic coronary angiography during screening for the trial, the associated complications were determined at 24 hours following the diagnostic procedure. Results: Over 5,000 patients were screened during a 4-year recruitment period at 18 major VA medical centers and the present cohort consists of 1,298 patients who underwent preoperative coronary angiography. Surgical indications for vascular surgery included an expanding aortic aneurysm (AAA) (n = 446; 34.4%) or arterial occlusive disease with either claudication (n = 457; 35.2%) or rest pain (n = 395; 30.4%). A total of 39 patients had a confirmed complication with a major complication identified in 17 patients (1.3%). Complication rates were higher in patients with arterial occlusive symptoms compared with expanding aneurysms (1.8% vs. 0.5%; P = 0.07) and were not dissimilar with femoral (2.8%) versus nonfemoral (4.7%) access sites (P = 0.42). Conclusions: Coronary angiography is safe in patients with peripheral arterial disease undergoing preoperative coronary angiography. The complication rate is higher in patients with symptoms of arterial occlusive disease.

Original languageEnglish (US)
Pages (from-to)369-374
Number of pages6
JournalJournal of Interventional Cardiology
Volume21
Issue number5
DOIs
StatePublished - Oct 2008

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Peripheral Arterial Disease
Coronary Angiography
Coronary Vessels
Blood Vessels
Arterial Occlusive Diseases
Safety
Peripheral Vascular Diseases
Aortic Aneurysm
Thigh
Aneurysm
Pain

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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Diagnostic coronary angiography in patients with peripheral arterial disease : A sub-study of the coronary artery revascularization prophylaxis trial. / Garcia, Santiago; McFalls, Edward O.; Goldman, Steven; Larsen, Greg C.; Littooy, Fred; Moritz, Thomas E.; Reda, Domenic J.; Ward, Herbert B.; Shunk, Kendrick; Hattler, Brack.

In: Journal of Interventional Cardiology, Vol. 21, No. 5, 10.2008, p. 369-374.

Research output: Contribution to journalArticle

Garcia, Santiago ; McFalls, Edward O. ; Goldman, Steven ; Larsen, Greg C. ; Littooy, Fred ; Moritz, Thomas E. ; Reda, Domenic J. ; Ward, Herbert B. ; Shunk, Kendrick ; Hattler, Brack. / Diagnostic coronary angiography in patients with peripheral arterial disease : A sub-study of the coronary artery revascularization prophylaxis trial. In: Journal of Interventional Cardiology. 2008 ; Vol. 21, No. 5. pp. 369-374.
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abstract = "Background: Although patients in need of elective vascular surgery are often considered candidates for diagnostic coronary angiography, the safety of this invasive study has not been systematically studied in a large cohort of patients scheduled for an elective vascular operation. The goal of this sub-study of the Coronary Artery Revascularization Prophylaxis (CARP) trial was to assess the safety of coronary angiography in patients with peripheral vascular disease. Methods: The CARP trial tested the long-term benefit of coronary artery revascularization prior to elective vascular operations. Among those patients who underwent diagnostic coronary angiography during screening for the trial, the associated complications were determined at 24 hours following the diagnostic procedure. Results: Over 5,000 patients were screened during a 4-year recruitment period at 18 major VA medical centers and the present cohort consists of 1,298 patients who underwent preoperative coronary angiography. Surgical indications for vascular surgery included an expanding aortic aneurysm (AAA) (n = 446; 34.4{\%}) or arterial occlusive disease with either claudication (n = 457; 35.2{\%}) or rest pain (n = 395; 30.4{\%}). A total of 39 patients had a confirmed complication with a major complication identified in 17 patients (1.3{\%}). Complication rates were higher in patients with arterial occlusive symptoms compared with expanding aneurysms (1.8{\%} vs. 0.5{\%}; P = 0.07) and were not dissimilar with femoral (2.8{\%}) versus nonfemoral (4.7{\%}) access sites (P = 0.42). Conclusions: Coronary angiography is safe in patients with peripheral arterial disease undergoing preoperative coronary angiography. The complication rate is higher in patients with symptoms of arterial occlusive disease.",
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AU - McFalls, Edward O.

AU - Goldman, Steven

AU - Larsen, Greg C.

AU - Littooy, Fred

AU - Moritz, Thomas E.

AU - Reda, Domenic J.

AU - Ward, Herbert B.

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