AORTOGRAFIYA

From Big Medical Encyclopedia

AORTOGRAFIYA (Greek aorte an aorta + I write graphö, I represent) — X-ray inspection of an aorta and its branches after filling of a gleam with a contrast agent. It is for the first time made in 1925 by Dos R. Dos Santos and described by it in 1929. And. it is intended for recognition of anomalies of development and pathology aortas (see) and its main branches (first of all atherosclerosis and occlusal defeats), and also for diagnosis of a number of diseases of bodies of a chest and abdominal cavity. Contraindications to And. are: an idiosyncrasy to iodide drugs, sharply expressed cardiovascular insufficiency, the acute and progressing diseases of a liver, kidneys, a pulmonary tuberculosis.

Administration of contrast medium (Hypaque, Urokonum, Verografinum, Urografinum) at And. one of three ways can carry out: 1) catheterization of an aorta through a peripheral artery; 2) a direct puncture of an aorta at various level; 3) puncture of an interatrial partition (kardioaortografiya). Gained the greatest distribution kateterizatsionny And. It is made by means of a transdermal puncture or an exposure of one of peripheral arteries: carotid artery, vessels of upper extremities (beam, humeral artery), vessels of the lower extremities (deep artery of a hip, femoral artery). After premedication of the patient stack on a back, carry out a catheter to an artery and under control of X-ray television advance to necessary level in an aorta. For prevention of a blood coagulation in a catheter or fibrinferment of vessels enter solution of heparin in cultivation into a catheter 5000 — 10 000ED on 2000 ml of isotonic solution of sodium chloride. Location of the end of a catheter is checked by means of trial introduction of a small dose of a contrast agent.

Fig. of Aortogramm at an obliterating endarteritis. Occlusion of the left general ileal artery.

At And. 75% enter solution of a contrast agent the automatic syringe under pressure of 5 — 8 atm at the rate of 0,5 — 1 ml on 1 kg of body weight of the patient and at the same time carry out high-speed serial shooting. In cases when it is impossible to carry out catheterization of an aorta (atherosclerotic occlusion of an artery, the small diameter of a gleam), apply its puncture.

Depending on indications and the level of administration of contrast medium it is possible to receive on the roentgenogram the image of the ascending department, an arch and the descending department of an aorta and its branches.

Translumbar And. it is shown for a research of belly department of an aorta and branches departing from it. It is carried out under a local anesthesia. The patient is stacked on a table of a X-ray apparatus in situation on a stomach. The puncture is made a needle 15 cm long with a diameter of gleam of 1,2 mm at the different levels: upper — is higher than an otkhozhdeniye of a celiac trunk, lower — under the place of an otkhozhdeniye of renal arteries. To Eagle stick at distance of 8 — 10 cm from acanthas of vertebrae on bottom edge of the XII edge to the left and advance on a body of the XII chest vertebra medially, ventrally and up. If advance of a needle is interfered by a body of a vertebra, then it should be delayed and sent a little lateralno and ventrally to paraortalny cellulose, to-ruyu it is necessary to anesthetize. When the needle reaches a wall of an aorta, the pulsation of an aorta well is defined. During a puncture of a wall of an aorta «failure» of a needle is felt and the pulse jet of blood appears. In such situation the needle is fixed and attach the syringe filled with a contrast agent to it. Enter 3 — 5 ml of 0,5% of solution of novocaine and after this 35 — 40 ml of 75% of solution of a contrast agent (Hypaque, Urokonum, Verografinum, Urografinum) into an aorta. During the use of a seriograf pictures make at the time of administration of contrast medium with an interval 0,5 sec. (from 3 to 5 pictures); on a usual X-ray apparatus do one picture with the extended endurance (4 — 6 sec.). At carefully executed And. serious complications are not observed.

Upon termination of a research the needle is removed from an aorta and for several minutes left in paraortalny space to avoid accumulation in it of the blood arriving from the place of a puncture of an aorta. If a contrast agent was by mistake entered into thickness of a wall of an aorta or paraortalny cellulose, it is necessary to enter paraortalno 200 — 300 ml of 0,25% of solution of novocaine that promotes bystry cultivation of a contrast agent.

Do not use a direct puncture of a chest aorta in a crust, time since catheterization of an aorta is simpler method. The X-ray contrast inspection of an aorta allows to reveal anomalies of development (coarctation, an atresia), aneurisms, fistulas, fibrinferments, occlusions (fig.), and also to establish type and degree of collateral circulation.


Bibliography: Vinogradov V. V., Mazayev P. N. and Shapovalyants G. G. The selection angiography of abdominal organs and retroperitoneal space, M., 1971; Krakow N. I., etc. Value of a translumbar aortografiya in diagnosis of diseases of a ventral aorta and vessels of a basin, Vestn. hir., t. 82, L «4, page 122, 1959; Lopatkin N. A. Translyumbylnaya aortografiya, M., 1961, bibliogr.; Tikhonov K. B. Angiography, page 108, L., 1962; Cormier J. M e. Aortographie abdominale, P., 1966; Dos Santos R., Lamas A. et Pereira Caldas J. L’ariographie des membres de l’aorte et de ses branches abdominales, Bull. Soc. nat. Chir., t. 55, p. 587, 1929; Ludin H. Aortography, Stockholm, 1966.

P.N. Mazayev.

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