Lecture 2
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This document discusses various angiographic procedures including coronary angiography, thoracic angiography, and balloon angioplasty. Coronary angiography uses x-rays to visualize the heart's blood vessels and is used to diagnose coronary artery disease. Thoracic angiography examines the blood vessels of the chest including the aorta, lungs, and kidneys. Balloon angioplasty is a procedure to widen narrowed arteries by inflating a balloon at the site of blockage, sometimes accompanied by stent placement to keep the artery open. Risks of these procedures include vessel rupture, perforation, occlusion, embolism formation, and stent thrombosis.
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Lecture 2
- 2. Common types include: coronary angiography – to check the heart and nearby blood vessels cerebral angiography – to check the blood vessels in and around the brain pulmonary angiography – to check the blood vessels supplying the lungs renal angiography – to check the blood vessels supplying the kidneys 1/16/2021 Dr.Tayseer jamal Aldeen 2
- 3. Sites of catheter insertion :- Radial artery Femoral artery 1/16/2021 Dr.Tayseer jamal Aldeen 3
- 4. Thoracic aortography is an angiographic study of the aorta, the arch, the descending portion of the thoracic aorta and major branches…. 1/16/2021 Dr.Tayseer jamal Aldeen 4
- 5. The thoracic aorta extends from the aortic bulb to the diaphragm and is generally divided into three main sections: ascending aorta, arch, and descending aorta. The classic pattern of branching consists of a right brachiocephalic, left common carotid, and left subclavian artery 1/16/2021 Dr.Tayseer jamal Aldeen 5
- 6. Clinical Indications Clinical indications for thoracic angiography include the following: • Aneurysms • Vessel stenosis • Embolus • Trauma • Congenital abnormalities 1/16/2021 Dr.Tayseer jamal Aldeen 6
- 7. Catheterization The preferred puncture site for a thoracic aortogram is the femoral artery. Contrast Media The amount of contrast media for thoracic angiography is 30 to 50 mL 1/16/2021 Dr.Tayseer jamal Aldeen 7
- 9. An aneurysm is an abnormal bulge or ballooning in the wall of a blood vessel. "A proportion of these patients will go on to have a rupture 1/16/2021 Dr.Tayseer jamal Aldeen 9
- 10. An aneurysm is an abnormal bulge or ballooning in the wall of a blood vessel. "A proportion of these patients will go on to have a rupture 1/16/2021 Dr.Tayseer jamal Aldeen 10
- 11. Arch aortogram clarifies the saccular arch aneurysm arising distal to the origin of the left subclavian artery in addition to the fusiform aneurysmal dilatation of the lower descending aorta 1/16/2021 Dr.Tayseer jamal Aldeen 11 N O R M A L
- 12. coronary arteriography is a procedure that uses X-ray imaging to see heart's blood vessels. 1/16/2021 Dr.Tayseer jamal Aldeen 12
- 13. coronary arteriography indications Coronary artery disease (atherosclerosis) Myocardial infarction 1/16/2021 Dr.Tayseer jamal Aldeen 13
- 14. There are three arteries that run over the surface of the heart There is one artery on the right side and two arteries on the left side of the heart. The one on the right is known as the right coronary. On the left side, which is the main side, we have the left anterior descending (LAD) and then the left circumflex that supplies the side wall. When (LAD) is totally blocked or has a critical blockage, at the beginning of the vessel, it is known as the Widow Maker. 1/16/2021 Dr.Tayseer jamal Aldeen 14
- 17. Catheter coronary angiography 1/16/2021 Dr.Tayseer jamal Aldeen 17
- 18. Catheter coronary angiography 1/16/2021 Dr.Tayseer jamal Aldeen 18
- 19. Catheterization the femoral artery is the preferred site for catheterization . both right and left coronary arteries are routinely examined. Specially shaped catheters are designed to fit each of the coronary arteries. 1/16/2021 Dr.Tayseer jamal Aldeen 19
- 22. Contrast Media Approximately 30 to 40 mL of a nonionic, low- osmolar, water soluble iodinated contrast media is injected. The coronary arteries typically require 7 to 10 mL of contrast media per injection. 1/16/2021 Dr.Tayseer jamal Aldeen 22
- 23. Imaging The imaging rate for angiocardiography is very rapid, in the range of 15 to 30 frames per second, 1/16/2021 Dr.Tayseer jamal Aldeen 23
- 24. A series of oblique images is obtained to visualize the coronary arteries . Routinely, six views of the left coronary artery and two views of the right coronary artery are obtained. 1/16/2021 Dr.Tayseer jamal Aldeen 24
- 26. Balloon angioplasty A procedure used to widen narrowed arteries . typically to treat arterial atherosclerosis. A deflated balloon attached to a catheter (a balloon catheter) is passed over a guide-wire into the narrowed vessel and then inflated to a fixed size. 1/16/2021 Dr.Tayseer jamal Aldeen 26
- 27. The balloon forces expansion of the blood vessel and the surrounding muscular wall, allowing an improved blood flow. A stent may be inserted at the time of ballooning to ensure the vessel remains open, and the balloon is then deflated and withdrawn. 1/16/2021 Dr.Tayseer jamal Aldeen 27
- 28. Stent placement To assist in maintaining patency of the vessel. across the treated area during the angioplasty 1/16/2021 Dr.Tayseer jamal Aldeen 28
- 31. Balloon-expanding stent 1/16/2021 Dr.Tayseer jamal Aldeen 31
- 32. Risks and Complications Risks of angioplasty include 1. vessel rupture 2. vessel perforation, 3. vessel occlusion, 4. embolus formation 5. stent thrombosis, 1/16/2021 Dr.Tayseer jamal Aldeen 32
- 33. Thank you 1/16/2021 Dr.Tayseer jamal Aldeen 33