Screening angiography of supraaortic vessels performed by invasive cardiologists at the time of cardiac catheterization: indications and results

An aging population makes multiple vascular distributions more likely in patients arriving at the cath lab for coronary artery angiography or complete cardiac catheterization. Whether or not screening angiography of supraaortic vessels can be performed at the time of cardiac catheterization by the invasive cardiologist is still debatable. We sought to determine safety and utility of performing angiography of supraaortic vessels during cardiac catheterization. Medical records of all patients undergoing combined coronary and noncoronary angiography between May 1998 and December 2002 was retrospectively reviewed. One hundred and forty patients (80 males, mean age 67.8 ± 5.4 years) underwent combined cardiac catheterization and angiography of supraaortic vessels. Carotid artery angiography was performed at the same time of cardiac catheterization in 62 patients and subclavian artery angiography in the other 78 patients. Significant findings were reported in 32 (22.8%) patients. Complications included 1 transient ischemic attack and 2 carotid spasm resolved with nitrates infusion. In most cases the same standard catheters used during coronary angiography were used also for noncoronary angiography (119 patients, 85%). The incidence of significant angiographic findings and the relatively frequent association of CAD with supraaortic vessel atherosclerosis supports combined cardiac catheterization and angiography of supraaortic arteries but only in patients with multivessel coronary artery disease.