A total of 1,250 selective coronary arteriographic procedures were performed by the percutaneous transfemoral technique. There were no deaths. Local complications included delayed hemorrhage in 14 patients, peripheral emboli in 2, and thrombosis in 1. Cerebral complications included fibrin or air emboli in 3 and dislodgement of a mural thrombus by the catheter in 1. Cardiac complications included ventricular fibrillation in 11, myocardial infarction in 3, and profound hypotension in 1. With routine use of a transparent manifold and removal of the guide wire distal to the arch vessels, no cerebral emboli or myocardial infarctions have occurred in the last 500 examinations.