In Reply to: Re: Case 0400_04 -- The Safety of Pulmonary Angiography in Patients with Severe Pulmonary Hypertension posted by Frank Lynch on April 12, 2000 at 22:40:01:
I agree that technical advances over the last decade have made pulmonary hypertension a relative contraindication at best for performing pulmonary angiography.
An applicable article from 1987 strongly supports that "pulmonary angiography can be done safely despite the presence of severe pulmonary hypertension...and that the procedure leads to the identification of chronic, major-vessel thromboembolic pulmonary hypertension that may be alleviated by thromboendarterectomy" (Nicod, et al. Pulmonary Angiography in Severe Chronic Pulmonary Hypertension. Ann Intern Med. 1987; 107: 565-568.)
Their retrospective review included 67 consecutive patients with moderate to severe primary pulmonary hypertension or hypertension secondary to chronic thromboembolic pulmonary emboli and demonstrated no complications. The injection rate was 35+-10 mL at 18+-4 mL/sec from a main left or right injection site. The majority of injections involved ionic contrast media.