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TRANSLUMBAR AORTOGRAPHY IN THE STUDY OF RENAL DISEASE

Willard E. Goodwin, M.D.
AMA Arch Surg. 1957;74(2):294-296. doi:10.1001/archsurg.1957.01280080148023.
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In a paper which must give pause to all advocates of translumbar aortography, Conger, Reardon, and Arey report a case of uremic death with hemorrhagic diathesis, following diagnostic translumbar aortography in a 12-year-old child with hypertension. One can certainly sympathize with their statement, "Deaths due to diagnostic procedures are among the worst medical tragedies."

They carefully review the literature and tabulate a total of eight "renal" deaths and a number of other nonfatal renal complications following this procedure. They conclude, "In view of its proven nephrotoxic effect in many reported cases, renal angiography should not be used in the diagnosis of renal disease."

Although one instinctively sympathizes with the tragedy of their reported case, it seems too great a reaction to condemn a procedure which has proved diagnostic usefulness and which has been performed many thousands of times in skilled hands without the complications they observed.1,3,7

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