Unusual Coronary Emboli Associated with Coronary Arteriography

Five cases of sudden death, during or soon after coronary arteriography by the transfemoral technique, were apparently caused by a microscopically 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 evidence supports the hypothesis that this type of embolus results from the transfer of platelet deposits from the luminal and external surfaces 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.