Conger et al.1 recently reported a fatal case of renal failure following translumbar aortography. Hare2 also recorded a fatal case following such a diagnostic procedure, and Goodwin, in an editorial comment3 on Conger's report, discussed some of the hazards of this procedure.
In view of the work of Gaylis and Laws4 and in the light of our own experiences, it appears that some of the contentions made by Conger et al. are untenable, and it would seen unwise to allow the erroneous impressions likely to be created by their article to go unchallenged.
There are two aspects of Conger's reported case which deserve scrutiny: (a) the actual mechanism of renal failure, and (b) the technique of the examination—translumbar aortography.
A. Mechanism of Renal Failure
The authors have cited two possible causes of the renal failure: first, a chemotoxic effect due to an overdose of contrast medium,