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December 1959

Aortic Dissection Due to Translumbar Aortography, with Recovery Following Surgery

Author Affiliations

Oteen, N.C.
From the Veterans Administration Hospital, Oteen, N.C.

AMA Arch Surg. 1959;79(6):1023-1027. doi:10.1001/archsurg.1959.04320120165023

Renal and neurological complications are the commonest serious sequelae of abdominal aortography. It has become increasingly evident that in some cases these occasionally fatal complications have been brought about by aortic mural dissection following the injection of dye, with partial or complete occlusion of aortic branch vessels. That this sequence of events can occur was strongly suspected by Gaylis and Laws,1 who produced medial dissection experimentally in human abdominal aortas. However, McAfee,2 in a review of data on over 12,000 aortograms, was able to collect only two cases of dissection following aortography, both of which ended fatally. On the other hand, Wolfman and Boblitt3 reported four fatal cases from a series of 302 aortograms. In two of these the dissection directly contributed to the death. Fineberg and his associates4 described a case of gangrene of the large intestine believed to have resulted from this mechanism.