Renal Arteriogram


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Renal Arteriogram

  1. 1. <ul><li>A Renal Arteriogram is </li></ul><ul><li>also commonly called a </li></ul><ul><li>renal angiogram </li></ul><ul><li>A arteriogram is a X-ray </li></ul><ul><li>image of the arteries or </li></ul><ul><li>blood vessels of a particular </li></ul><ul><li>organ in this case it would </li></ul><ul><li>be the Kidneys(Renal). </li></ul><ul><li>A Fluoroscopic image of the </li></ul><ul><li>Kidneys can also be done to see </li></ul><ul><li>the movement of the kidneys </li></ul>
  2. 2. <ul><li>You Can’t eat or drink the night before the procedure so that you stomach is completely empty of all food. </li></ul><ul><li>You have to tell the doctor a list of your medication or any medication you may be allergic to. </li></ul><ul><li>An IV(intervenous) will be placed in you hand </li></ul>
  3. 4. <ul><li>The catheter will be removed you should lie completely still to stop any bleeding that may occur. </li></ul><ul><li>You can begin to eat and an IV fluid will be given to help flush all the dye that is left. </li></ul><ul><li>Your Blood pressure an other vital signs remained monitored. </li></ul><ul><li>Some renal angiograms take half an hour others can take longer like an hour or two. </li></ul>
  4. 5. <ul><li>Procedure: Translumbar Puncture </li></ul><ul><li>Projection: Posteroanterior(PA) </li></ul><ul><li>Patient Position : Patient Prone, </li></ul><ul><li>Centered to table, arms at side of </li></ul><ul><li>body head in lateral position shins </li></ul><ul><li>supported, slight internal rotation of legs </li></ul><ul><li>Central ray : Vertical beam to center of film, through midsagittal plane at level of kidney hilum </li></ul><ul><li>Anatomy : Renal arteries, aorta and associated major branches. </li></ul>
  5. 6. <ul><li>The translumbar puncture is not commonly used for a renal angiogram for several reasons. </li></ul><ul><li>The patient must lay in the </li></ul><ul><li>prone position during the </li></ul><ul><li>procedure </li></ul><ul><li>Another reason is that the </li></ul><ul><li>opening of the renal vessels </li></ul><ul><li>are located dorsally, and to </li></ul><ul><li>make the vessels radiopaque </li></ul><ul><li>so they can show up on the </li></ul><ul><li>x-ray is made more difficult </li></ul><ul><li>due to the position of the </li></ul><ul><li>patient and the specific gravity of </li></ul><ul><li>the contrast agent. </li></ul>
  6. 7. <ul><li>The Position of the patient is limited to the prone position. The needle location makes it impossible for any other position or excessive movement. </li></ul><ul><li>The patient is centered to the table with his arms alongside the body in a comfortable position. </li></ul><ul><li>The shins should be supported, and the legs should be placed in internal rotation. </li></ul><ul><li>The kidneys generally extend between the 12 th thoracic and 3 rd lumbar vertebras when the patient is recumbent. </li></ul><ul><li>The central ray should be positioned to the hilum of the kidney </li></ul>
  7. 8. <ul><li>Procedure: Percutaneous catheter (Seldinger Method) </li></ul><ul><li>Projection : Anteroposterior(AP) </li></ul><ul><li>Patient Position : Patient prone, centered to table, arms at side of body, head in lateral position, shins supported, slight internal rotation of legs </li></ul><ul><li>Central Ray : Vertical beam to center of film at level of kidney hilum </li></ul><ul><li>Anatomy : Renal arterial supply, accessory renal arteries </li></ul>
  8. 9. <ul><li>A Percutaneous Catherization or Seldinger method is a specialty procedure that is only done under the supervision of a radiologist. </li></ul><ul><li>A Seldinger method is done by first having </li></ul><ul><li>the radiologist inserts a wire into a large </li></ul><ul><li>artery of the groin. The wire has a small </li></ul><ul><li>tube called a catheter attached to it the </li></ul><ul><li>catheter is lead into the kidneys where </li></ul><ul><li> the doctor will insert a dye through the </li></ul><ul><li>catheter and into the patients kidneys. </li></ul><ul><li>Once the dye has settled an x-ray will be </li></ul><ul><li> taken this x-ray will bring contrast to the </li></ul><ul><li>arteries which will make for an easy </li></ul><ul><li> diagnosis. </li></ul>
  9. 10. <ul><li>The most common position will be the recumbent supine. </li></ul><ul><li>The technique of catheter placement, however, allows more flexibility in patient positioning than the previous method. </li></ul><ul><li>Obliques may be required for a better demonstration of the origin of the renal vessels. </li></ul><ul><li>The central ray is again at the level of the kidney hilum </li></ul>
  10. 11. <ul><li>The injection equipment required for a renal angiogram varies </li></ul><ul><li>In the translumbar approach, the contrast agent can be injected by hand or by the use of an automatic injector. </li></ul><ul><li>Sterile trays and packs are required for </li></ul><ul><li>the procedure. </li></ul><ul><li>For the catheterization procedure a special </li></ul><ul><li>catheterization pack is required. In a renal </li></ul><ul><li>angiogram a curve in the catheter is </li></ul><ul><li>required. </li></ul><ul><li>As in any angiogram emergencies may happen so you need emergency equipment and supplies. </li></ul>
  11. 12. <ul><li>Aneurysm- This disease most commonly is found in arteries. </li></ul><ul><li>An aneurysm is a bulge of blood </li></ul><ul><li>In an artery this can become dangerous </li></ul><ul><li>If the artery breaks </li></ul><ul><li>Aneurysm only symptom is pain and </li></ul><ul><li>Is usually detected through x-rays. </li></ul><ul><li>Treatment is drugs or surgery </li></ul><ul><li>Depending on the size of the </li></ul><ul><li>Aneursm. </li></ul>
  12. 13. <ul><li>Stenosis is an abnormal narrowing of blood vessels </li></ul><ul><li>Renal artery stenosis can </li></ul><ul><li>become serious when left </li></ul><ul><li>untreated </li></ul><ul><li>The kidneys release a </li></ul><ul><li>hormone know as renin to </li></ul><ul><li>decrease blood pressure if </li></ul><ul><li>the kidneys can continue to </li></ul><ul><li>release renin this can result </li></ul><ul><li>in hypertension </li></ul>
  13. 14. <ul><li>Renovascular hypertension is the narrowing of the blood vessels in the kidneys </li></ul><ul><li>It is easily seen on a renal angiogram and can be treated by angioplasty or stenting (man made tube inserted into the </li></ul><ul><li>artery) of the renal </li></ul><ul><li> arteries. </li></ul>
  14. 15. <ul><li>arteriovenous malformation is an abnormal connection between artery and veins it arises the embryo. </li></ul><ul><li>Arteriovenous malformation usually shows no symptoms and is found during autopsy but can be discovered in a renal angiogram. This type of disorder can cause serious damage to the spinal cord and brain. </li></ul>
  15. 16. <ul><li>Thrombosis is a blood clot that blocks an artery and disrupts the </li></ul><ul><li>flow of blood. </li></ul><ul><li>Thrombosis can be </li></ul><ul><li>caused by a blow to the </li></ul><ul><li>abdominal area or a </li></ul><ul><li>tumor that obstructs the </li></ul><ul><li>renal artery or vein </li></ul><ul><li>Treatment of thrombosis </li></ul><ul><li>is anticoagulation medication </li></ul>
  16. 17. <ul><li>Since renal angiogram deals with x-ray there is always a risk of too much radiation exposure since multiple x-rays will be taken </li></ul><ul><li>There is always a risk when you deal with a blood vessel especially arteries which are high pressured blood vessel </li></ul><ul><li>Hemorrhage due to a punctured blood vessel </li></ul><ul><li>Injury to nerves </li></ul><ul><li>Embolus-clot of a blood vessel </li></ul><ul><li>Hematoma </li></ul><ul><li>Infection </li></ul><ul><li>Kidney Failure </li></ul>