Unusual Coronary Emboli Associated with Coronary Arteriography

¹ Departments of Pathology, Cardiology, and Surgery, Veterans Administration Hospital, Oteen, North Carolina

Five cases of sudden death, during or soon after coronary arteriography by the transfemoral technique, were apparently caused by a mocroscopically unique embolus characterized by tightly packed tortuous and homogeneous cords of material which appear to be aggregated platelets without significant fibrin or blood cells. The incidence of this complication during the past 30 months was 1.5 percent. Clinical and experimental evedence supports the hypothesis that this type of embolus results from the transfer of platelet deposits from the luminal and external surfaes of intra-arterial catheters or from guidewires to the coronary artery. This complication should be preventable either by the use of adequate systemic heparinization or by the use of a different coronary arteriographic technique.