9.26.11+-+Angiography

OBJECTIVES: 1. Describe how angiography is performed. Describe the vessels through which catheters are inserted, how the catheters are snaked through the arteries, and how the injected arteries are visualized. Angiography: Examination of bld vessels using x-rays following the injection of radiopaque substance
 * Use femoral artery usually
 * Artery hole is dilated to fit catheter and sheath
 * Manipulation of thin catheter through vessels over a guide wire
 * Injection of iodine-based contrast agent through catheter into artery

2. List some of the major risks to the patient associated with angiography.
 * Hematoma
 * Pseudoaneurysm
 * Dissection of artery
 * Emboli from catheter/wire manipulation
 * Thrombosis and/or emboli
 * Contrast allergy/reaction
 * Renal compromise from contrast
 * Radiatino

3. Briefly, describe how regular angiography differs from CT-angiography and MRangiography.
 * CTA-advantages
 * Fast
 * Anatomic relationship information
 * No arterial puncture
 * Various views of images
 * CTA-disadvantages
 * Dependent on scanner
 * less distinction between a. and v.
 * contrast rxn
 * radiation
 * contrast timing issues
 * MRA-advantages
 * no ionizing radiation
 * Some flow information
 * removes surrounding info
 * manipulate views
 * can do with or without contrast
 * MRA-disadvantages
 * Motion sensitive
 * May be dependent on flow rates
 * Less anatomic detail
 * longer exam than CTA
 * + or - ability to see other structures

4. Recognize the patterns seen in angiographic images (as seen in plane X-rays images) of the following arteries: Celiac trunk Splenic artery Common hepatic artery Superior mesenteric artery Inferior mesenteric artery Renal artery Aorta Coronary arteries Portal Vein