Aortografiya

Description:

Aortografiya (Greek aorte — an aorta and grapho — I write down) — a method of obtaining the image of an aorta and its branches on the roentgenogram after filling of a gleam of an aorta with a contrast agent. Aortografiya of a chest aorta is applied to morphological and functional diagnosis of diseases of an aorta and its branches, some diseases of a lung (a tumor, a cyst) and mediastinums. Aortografiya of a ventral aorta spleens, intestines use for diagnosis of diseases of a liver, kidneys, a uterus, a bladder, and also for definition of the place of placental presentation. Special value has a method of a renal angiography. It serves for recognition of such diseases of kidneys as anomalies, solitary cysts, a polycystosis, pyelonephritis, hypernephroid cancer, a hydronephrosis, diseases of renal vessels.
Aortografiya is contraindicated at hypersensitivity to iodine, heavy cardiopulmonary insufficiency, a sharp abnormal liver function or kidneys, an active pulmonary tuberculosis and a thyrotoxicosis.
Aortografiya can be executed by a direct puncture of an aorta or its sounding through beam, humeral, sleepy arteries through a femoral artery or its deep branch. Aortic catherization through a naked beam artery or a deep branch of a femoral artery is the safest. The best method is aortic catherization by a puncture of a femoral artery 2 cm lower than a pupartovy sheaf. On a needle trocar with a diameter up to 2 mm, 8 — 10 cm long enter the flexible conductor into an aorta. After removal of a needle on the conductor enter into an aorta on necessary distance the X-ray contrast probe. For a bleeding stop from the place of a puncture it is necessary to press an artery within 20 min. In all cases when long stay of the probe in a vessel gleam in the course of the research is necessary, it is necessary to enter before a contrast agent into a blood flow 10 — 20 ml of 0,5% of solution of novocaine during 2 — 3 sec., and also for prevention of a thrombogenesis — heparin at the rate of 2500 PIECES on 1 l of normal saline solution at an o'clock of a research.
The puncture of chest department of the descending aorta is made under anesthetic or local anesthesia. The patient lies on a stomach. The needle is entered at the level of VIII — the X chest vertebra, отступя from the average line of a backbone on 3 — 5 cm to the left, and advanced towards a body of an overlying vertebra. At a bone obstacle the needle is delayed and, directing it several knaruzha, again advance deep into, up to an aorta wall. For prevention of a puncture of a pleura under it enter 100 — 200 ml of normal saline solution or solution of novocaine. At an aorta wall puncture fingers of the doctor feel the feeling similar to that which arises at a puncture of a firm meninx.
Equipment of an abdominal aortografiya: the patient lies on a stomach; a needle with a diameter up to 1,8 mm, 15 cm long enter directly under the XII edge, отступя from the average line of a backbone to the left on 8 — 10 cm. For a renal angiography the aorta should be punktirovat at the level of the middle of a body of the I lumbar vertebra; for hepatic, splenic or verkhnebryzheechny arteriography — at the level of XII of a chest vertebra.
As a contrast agent Cardiotrastum, Diodonum, трийодтраст, 70% Hypaques other at the rate of no more than 1 ml on 1 kg of body weight are used. A contrast agent is entered with a speed of 10 ml during 1 sec. For an aortografiya use the X-ray apparatus equipped with a tube with the rotating anode and a seriograf. X-ray films make with exposure 0,1 — 0,4 sec. and the speed of 1 a picture in a second.