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Pulmonary Angiography

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Pulmonary angiography is the definitive test for diagnosis of pulmonary embolism (Gill & Nahum 2000). It involves percutaneous catheterization and injection of contrast dye into a pulmonary artery branch (Gill & Nahum 2000). It is an expensive test and is associated with a significant risk of complications (e.g., hemorrhage, embolus, nerve injury). Relative contraindications include significant bleeding risk, allergy to contrast medium, and renal insufficiency (Gill & Nahum 2000). It is associated with a mortality rate of up to 0.5% (Newman 1989; Stein et al. 1992). Pulmonary angiography is most commonly used when ventilation-perfusion scanning is non-diagnostic but clinical suspicion remains high (Tapson et al. 1999). A negative pulmonary angiogram excludes clinically relevant pulmonary embolism (Tapson et al. 1999; Gill & Nahum 2000).