Angiography

Angiography (from the Greek. angeion - vessel and grapho - writing, depict; a synonym for fatografi, from lat. vas - vessel) is the method of roentgenologic examination of the blood vessels using contrast agents entered in their clearance. For the first time such a study carried out by anatomists on the corpses (P. I. Dyakonov, 1897). Creating a harmless water-soluble halogen-containing contrast agents (cardiotest, diodon, tsiotras, Eurocon, urographine and others) made possible a wide application of this method in clinical practice. For the first time in his lifetime contrast examination of the veins in the Soviet Union made S. A. Reinberg in 1924
At present, the developed technique of contrasting research vessels of most organs (angioneurology, angiocardiography, splenoportography, angiocardiografia, angioneiropatia, aortography and others). A single injection of a contrast agent allows to get the image veins, and then and arteries of the investigated organ [angiocardiography (see), angioneurology] or, on the contrary, first of arteries and veins then (angiocardiografia; Fig. 1.1 and 1.2). In clinical practice was widespread methods of angiography, allowing you to study or just artery (arteriography), or only Vienna (venography; synonym phlebography, from the Greek. phlebs, phlebos - Vienna). For the diagnosis of diseases of major vessels and some diseases, supplied by branches of aorta, applied aortography (see). For a contrasting study of venous vessels retroperitoneal space mainly in urological practice is applied binocularity; the contrast agent injiziert through a tube introduced into the femoral vein. Angiography allows to get accurate information about the anatomy of blood vessels, variants of their branches, pathological changes of blood vessels and their lumen (expansion, contraction, obliteration, and so on), pathological messages (arterio-venous fistula and aneurysm). Angiography can judge the functional condition of blood vessels, to calculate the speed of blood flow, determine Hypo - or hypertension, the Department's vascular system.
Indication for angiography serve not only pathological condition of the vessels, but also various pathological processes in different bodies. Angiography is contraindicated in patients with individual intolerance contrast to this matter, which is determined by a special pre-breakdown: a few days before the study intravenously injected 1-2 ml of contrast agent and monitor patients during the day; the appearance of rash, conjunctivitis, rhinitis, dyspeptic phenomena and disorders of the heart shows intolerance to medication.
X-rays vessels can be obtained by different methods: 1) continuous shooting, 2) scenografie and 3) the long exposure. Angiography can be run on any x-ray machine. Serial angiography requires special x-ray machines, providing the change of the staff roll films, however, a series of x-rays can be obtained on a conventional x-ray machine, equipped with a special set-top box, which allows quick change cassettes (1-2 1 sec.). Stenograficheskiy method allows to obtain images of vessels to a considerable extent, such as arteries throughout the lower limbs. Either the x-ray tube advance along the limbs simultaneously with the movement of the contrast agent within the blood vessels, or promote Desk with stationary tube. Simpler angiography with long exposure: the x-ray tube set at such a height from the investigated organ that into the frame the whole body, and produce x-rays during the whole period of contrast agent within the blood vessels of the studied area (2-3 sec.).
The choice of method of injection of contrast substance in the blood vessels is determined by the nature of the pathological process and the necessity of obtaining images of the veins or arteries.
Arteriogram receive the injection of a contrast agent into the lumen of the artery methods of puncture, percutaneous sensing or exposure artery subsequent puncture or angiotomy. Puncture method is most often used to obtain images of the arteries of the brain and limbs (Fig. 2). Percutaneous sensing artery on the Seldinger followed by arteriography is indicated in cases of necessity of obtaining images of the arteries, not available puncture (electoral arteriography renal arteries, celiac, iliac, and others). For this dotted line in a major artery in the upper or lower limbs, conduct a first probe into the aorta, and then under visual control (x-ray) and in the study artery (Fig. 3). The method of exposure artery subsequent puncture or sounding used with the expressed atherosclerosis of the arteries.
Venography produce methods: 1) percutaneous puncture of Vienna, 2) venesection and kanalirovaniya Vienna, 3) puncture parenchymal organ (spleen, cavernous bodies of the penis), 4) the puncture of bone (heel - to obtain images of the deep veins of the lower extremities, pubic or iliac - deep veins of the pelvis, ribs or sternum - veins mediastinum) (see Splenoportography, Phlebography)..
Widely used angiography during the operation (operating ortografia, arteriography lower extremities, carotid and vertebral arteries) to diagnose or monitor the effectiveness of surgical intervention.

Fig. 3. Percutaneous sensing artery on the Seldinger: 1 - puncture artery needle-free article; 2) the introduction of elastic conductor through a needle into the lumen of the artery; 3 - needle removed; 4 - stringing probe on a wire; 5 - conducting a probe into the lumen of the artery; in - conductor removed, the probe is pushed into the artery.