934-29 Coronary Angioscopy Safety Survey: European Multicenter Experience

Percutaneous coronary angioscopy (CA) which allows direct visualization of the interior of the coronary arteries has potentially widespread application in research and as an adjunct to coronary interventional procedures. To assess the safety of coronary angioscopy, we surveyed 27 European centers where angioscopy procedures were performed with the same angioscopic system Image Cath (Baxter).A total of 1746 (mean 1.62 per patient) angioscopy procedures were performed in 1076 patients up to March 1994. Fifteen centers had performed less than 25 procedures, 6 centers between 25 and 50 procedures and 6 centers between 50 and 200 procedures. Information regarding the total number of procedures, the number of major clinical complications and the number of minor complications (without clinical sequelae) was requested. Major complications related or probably related to angioscopy were death n=1 (0.09%), acute myocardial infarction n=2 (0.19%) and emergent coronary artery bypass grafting n=5 (0.46%). Coronary dissection related to cuff inflation n=15 (1.39%), to manipulation of the fiber n=14 (1.30%) or to the passage of the guidewire n=2 (0.19%) occurred in a total of 31 (2.88%) patients. Stent implantation for dissection was required in 5 (0.46%) patients. Ventricular fibrillation during imaging, that required cardioversion, occurred in 18 (1.67%) patients, Complications were significantly less frequent when operator experience was>50 patients (2.0%) than when operator experience was 25–50 patients (6.5%) or<25patients (5.9%).In conclusion, clinical adverse events related to the performance of coronary angioscopy are rare. The rate of adverse events is related to operator experienc