By Prof. Dr. W. Wenz (auth.)
The wonderful but uncomplicated notion of introducing a catheter percutaneously into an artery, with no first dissecting it loose, utilizing a versatile consultant twine, has ended in a really innovative leap forward in belly x-ray diag nosis (SELDINGER, 1953). meanwhile, equipment and methods for injecting distinction media into a number of vessels became principally standardized; innumerable guides have seemed which care for each available element of angiographic procedure and interpretation. This quantity is designed to provide our adventure with stomach angiography. We intentionally avoided any systematic dialogue of the genitourinary tract, which has been thoroughly handled within the literature, additionally with recognize to angiographic findings. Our curiosity within the retroperitoneal zone relies in general on its importance in differential prognosis. In ten years of angiographic job, our division had made winning use of an easy process which seems compatible additionally for smaller hospitals. we want to indicate its diagnostic strength and, even as, to stipulate its boundaries. Our adventure embraces 2804 belly angiograms, which now we have categorized based on medical and morphologic anatomical standards. Their diagnostic interpretation has been in comparison with the surgical or histopathological effects. this can aid others to prevent mistakes of the kind which we came upon in our personal paintings. Angiographic analysis calls for not just familiarity with common radiographic anatomy, but additionally particular wisdom of angiographic patho morphology. now we have attempted to spot these good points which typify the person findings and to derive therefrom legitimate generalizations by means of uncomplicated sketches.
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Extra info for Abdominal Angiography
These small pressure swings can be explained by the 21 Angiographic Technique slower injection (manual) and the smaller quantities of contrast medium used. In contrast to the examination techniques mentioned so far, translumbar aortography may be performed under general anesthesia. In these cases, blood pressure measurements were not initiated until after the induction of anesthesia, with the patient shifted to a prone position, when the pressure levels were stabilized. expansion (averaging 12 mm Hg in translumbar aortography), followed by a pressure drop averaging 27 mm Hg 20 to 40 seconds later.
Bleeding from the translum bar puncture requiring surgical repair. On the day after the operation the patient died of postoperative consumption coagulopathy. Apart from some clinically uneventful extravasations during aortography and innocuous hematomas at the catheter entry site in the inguinal region, we witnessed the following more serious incidents: The role of hypertension is readily apparent from this tabulation. However, sizable injury to the artery from introduction of the catheter in previous angiographic examinations and incomplete bed rest by the patients after the examination must also be incriminated.
However. when different catheter lengths and calibers were compared in that thromboembolic complications were more frequent after the use of long and large-caliber catheters. JACOBSSON (1968) was able to show that platelets tend to deposit on the catheter in the form of reversible aggregations in much the same way as they do on a damaged vessel wall. Under the action of locally formed thrombin this structureless aggregation may change into an irreversible platelet thrombus. This mechanism-in contrast to development of the so-called red thrombus-is refractory to anticoagulants.