Aortography

Aortography (gr. aorte - aorta and grapho - write) - a method of obtaining images of the aorta and its branches on the radiograph after filling of the lumen of the aorta by contrast agent. Aortography thoracic aorta is used for morphological and functional diagnostics of diseases of the aorta and its branches, some of lung diseases (tumors, cysts) and mediastinum. Aortography abdominal aorta is used for diagnostics of diseases of liver, kidneys, spleen, intestines, uterus, bladder, and also for definition of a place of placenta previa. Of particular importance is the method of renal angiography. It serves for detection of diseases of the kidneys, anomaly, solitary cysts, polycystic, pyelonephritis, gipernefroidnyi cancer, hydronephrosis, diseases of the renal vessels.
Aortography is contraindicated at hypersensitivity to iodine, heavy cardio-pulmonary distress, severe violations of the liver or kidney, active tuberculosis lungs and thyrotoxicosis.
Aortography can be made direct puncture aorta or her probing through radiation, shoulder (Fig. 1), carotid artery through the femoral artery or her deep branch. Most safely sounding of the aorta via Nude radial artery or deep branch femoral artery. The best method is sounding of the aorta by puncture femur artery 2 cm below papatowai ligaments. The needle-trocar with a diameter up to 2 mm, a length of 8-10 cm injected into the aorta flexible conductor. After removal of the needle Explorer into the aorta enter the necessary distance radiopaque probe. To stop bleeding from the puncture site, you must applying pressure for 20 minutes In all cases, when a longer stay of the probe into the vessel lumen in the research process need before by contrast agent to enter into the bloodstream 10-20 ml of 0.5% solution novokaina within 2-3 seconds, and also for the prevention of thrombosis - heparin-based 2500 IU per 1 l of physiological solution for research hour.
Puncture descending thoracic aorta is performed under General anesthesia or local anesthesia. The patient lies on his belly. The needle is injected at the level of the VIII-X thoracic vertebra, some distance from the centre line of the spine at 3-5 cm left, and advance towards the body overlying vertebra. When bone obstacle pulled the needle and, directing it slightly outwards, again promoting deeper, down to the wall of the aorta. To prevent puncture of the pleura under it enter 100 to 200 ml of physiological solution, or solution novokaina. If the puncture of the aortic wall doctor's fingers feel a sense, similar to that which occurs when a puncture of the Dura mater.
The technique of abdominal aortografii: the patient lies on his belly; needle diameters up to 1,8 mm, length 15 cm injected directly under the XII edge, some distance from the centre line of the spine to the left on 8-10 see For renal angiogram of the aorta should puncturevine at the middle of the body I lumbar vertebra; hepatic, splenic or verhnebureinski arteriography - at a level of XII thoracal vertebra (Fig. 2).
As a contrast substances are used cardiotest, diodon, trio-trust,70% hipace other to a maximum of 1 ml per 1 kg of body weight. Contrast medium is injected at a rate of 10 ml for 1 sec. For aortografii use x-ray machine, equipped with a tube with rotating anode and serigraphs. X-rays are produced with the exposition of 0.1-0.4 sec. and the rate of 1 picture per second. Cm. also Angiocardiography, Aorta (x-ray analysis of anomalies).

Fig. 1. Aortogram ascending aorta method sensing through the right brachial artery.
Fig. 2. Renal arteriogram method of puncture of the abdominal aorta.