ARTERIOGRAPHY

From Big Medical Encyclopedia

ARTERIOGRAPHY (Greek arteria + - graphö to write, represent) — X-ray inspection of arteries by introduction to a gleam of a vessel of a contrast agent with the subsequent X-ray analysis. And. apply both to diagnosis of defeats of vessels, and to recognition of diseases of many bodies — a brain, lungs, a liver, kidneys, a uterus etc. And. peripheral vessels Berberikh and Girsh for the first time made (J. Berberich, S. Hirsch, 1923). In the USSR the Ampere-second the diagnostic purpose for the first time were executed by V. V. Krestovsky (1930), G. P. Kovtunovich (1932).

And. it is widely used at arteriovenous aneurisms and fistulas, traumatic ruptures of arteries, diseases of the tied-up vessel, obliterating diseases, aneurisms and thrombosis of arteries. And. gives the chance to study anatomo-topographical features of arteries, their functional condition, speed of a blood flow, localization and extent of pathological process, a way of roundabout blood circulation, and also permeability of a vascular wall. Contraindications to use And.: serious condition of the patient, acute diseases of a liver, kidneys, pancreas and intolerance of iodide drugs.

Applied at And. triyodirovanny contrast agents (Hypaque, Verografinum) contain from 65 to 85% of iodine. At introduction to a vascular bed they are in a short space of time brought from an organism by kidneys.

And. it can be executed in two ways: open, i.e. by a surgical exposure of a blood vessel, at poorly developed vascular network it is also difficult for the palpated artery, or closed — a transdermal puncture of an artery: under a local anesthesia on site punctures through a needle quickly enter 20 — 40 ml of 50 — 70% of solution of a contrast agent into a gleam of the pulsing artery.

At careless performance And. the puncture of an opposite vascular wall therefore a contrast agent injects paravazalny cellulose is possible; at emergence of painful infiltrates it is necessary to enter 0,25% into the fabrics surrounding a vessel solution of novocaine. At puncture And. the needle is connected to the syringe a rubber tube that facilitates technical performance of a research. And. make also transdermal introduction of a vascular catheter on Seldingera: the vascular catheter is entered on a blood flow or retrogradno. At retrograde And. for administration of contrast medium it is necessary to use the mechanical syringe or an injektor. For the prevention of formation of blood clots around the catheter entered into a vascular bed it is necessary to pour in warm isotonic solution of sodium chloride with small impurity of heparin. At an obliterating disease with the broken passability of the main arteries of a basin or a hip it is reasonable to make an aortografiya (see), and at hemilesion of a femoral artery the vascular catheter can be entered into an artery of a healthy hip and at retrograde And. to receive the contrast image of vessels of a sore extremity. It will allow to determine the level and extent of occlusion of the main vessel, a way of a roundabout blood-groove and an anatomo-functional condition of collaterals.

For And. it is possible to use ordinary stationary X-ray diagnostic devices, making serial pictures by means of special devices or single pictures with the extended endurance (from 4 to 6 sec.). In a crust, time apply X-ray apparatus with the automatic delivery of a film, and also electron-optical converters with use of filming and X-ray television.

The particularly important becomes And. during operation: in addition to specification of vascular pathology, And. on the operating table gives the chance in case of need to establish passability of a vascular transplant or anastomosis, i.e. to objectively estimate quality of plastic vascular surgery. Operation at the same time is carried out in specially adapted X-ray department or in the operating room where there is a powerful mobile X-ray apparatus. The repeated research can be executed in 5 — 7 days at the corresponding testimonies and joint consultations of the surgeon and radiologist.

Fig. 1, at the left. Arteriogramma of the right hip at atherosclerosis of a femoral artery. Tortuosity of a femoral artery is visible. Fig. 2, on the right. Arteriogramma of area of the right knee joint at an obliterating endarteritis: 1 — a normal main artery; 2 — the narrowed main artery; 3 — the obliterated artery

And. gives the chance to differentiate the nature of pathological process at various stages of a disease. At atherosclerosis of ileal and femoral arteries find: narrowing of a gleam of a vessel, a crenation of contours, defects of filling at the expense of atherosclerotic plaques, calcifications of a vascular wall, tortuosity of vessels (fig. 1), and in late stages — full disturbance of passability of a vessel. At an obliterating endarteritis observe narrowing of the main artery with accurate contours (fig. 2); at occlusion of a vessel the delimited stump with gyrose collaterals is visible. And. allows to reveal idiosyncrasies of vascularization of fabrics in the studied extremity in various phases of a Raynaud's disease and efficiency of therapeutic actions at this disease. Is important And. in differential diagnosis of new growths of soft tissues of extremities and a basin.

Arteriography radio isotope — look scintiangiography (see), applied to studying of a condition of arteries and the fabrics surrounding them. The essence of a research is that at introduction to a gleam of a vessel of 0,1 — 0,3 ml of radioactive drug 2 — 5 mkyur its cultivation in blood happens to the general activity rather slowly thanks to what receiving quite satisfactory contrasting of cardial cavities, an aorta and large arteries is possible.

Registration of passing of radioactive material on arteries is carried out by means of the scintillation camera (see. Stsintigrafiya ) with the subsequent filming of the received image. Considering need of administration of drugs with rather high activity, at radio isotope And. use isotopes only with low radio toxicity and short half-life (technetium-99m).

Radio isotope And. use for diagnosis of heart diseases, an aorta, a pulmonary artery, arteries of kidneys, a brain, etc.

Bibliography: Vilyansky M. P. Arteriography at an obliterating endarteritis, M., 1959, bibliogr.; A clinical angiography, under the editorship of M. I. Kuzin, etc., M., 1973; The Krakow N. I. and Mazayev of P. N. Angiografiya in surgery of vessels of extremities and a neck, page 21, M., 1964, bibliogr.; Petrovsky B. V. and Milonov of O. B. Hirurgiya of aneurisms of peripheral vessels, page 33, M., 1970, bibliogr.; Stepanova G. G. Given to arteriography at obliterating diseases of arteries of the lower extremities, Uzhhorod, 1962, bibliogr.; Tikhonov K. B. Angiography, page 67, D., 1962, bibliogr.; Angiography, ed. by H. L. Abrams, v. 1—2,L., 1961; Lumpkin M. Century of a. lake of Arteriography as an aid in the diagnosis and localization of acute arterial injuries, Ann. Surg., v. 147, p. 353, 1958; Maurer H.J. Zur arteriographi-schen Diagnostik von Knochensarkomen, Radiol, clin. biol. (Basel), Bd 38, S. 293, 1969; Seldinger S. I. Catheter replacement of the needle in percutaneous arteriography, Acta radiol. (Stockh.), v. 39, p. 368, 1953, bibliogr.; Vascular roentgenology, ed. by R. A. Schobinfeer a. F. P. Ru-zicka, p. 127, N. Y. — L., 1964, bibliogr.

P.N. Mazayev; G. A. Zubovsky (medical I am glad.).

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