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INTERVENTIONAL RADIOLOGY > LIMB ANGIO > Flashcards

LIMB ANGIO Flashcards

1
Q

What are the clinical indications of upper limb arteriography?

A
  • traumatic injury
  • bypass graft planning
  • atherosclerotic disease
  • acute limb ischemia
  • vascular anomalies
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2
Q

What are the contraindications of upper limb arteriography?

A
  • Patient history of severe or anaphylactic reaction to iodinated
    contrast
  • Patients with renal disease (eGFR <
    50mL/min)
  • Severe anemia
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3
Q

Approaches of upper limb arteriography?

A

-femoral artery site
- direct brachial artery

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4
Q

devices/equipment to be used in upper limb arteriography

A
  • Catheter (Headhunter, a sidewinder Ducor catheter)
  • Needles and Guidewires
  • Local Anaesthetic (10 ml. 1% lidocaine)
  • Fluoroscopy Machine
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5
Q

Contrast media used in upper limb arteriography

A

Low osmolality contrast material
- Isopaque Cerebral
- Hexabrix
- Telebrix 30

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6
Q

Procedure for upper limb arteriography

A
  1. Patients shouldn’t be dehydrated but food withheld for 6-10 hrs before the exam
  2. Patient will take a blood test
  3. Ask the patient allergies and medications
  4. Undress and put a hospital gown
  5. Apply local anesthesia
  6. Position hand flat on a padded arm board in an anatomic position
  7. Introduce catheter in transfemoral approach
  8. Administer heparin
  9. For the left subclavian artery, simply turn the tip of the catheter to the left, craniolateral with respect to the aortic arch.
  10. For the right subclavian artery, the catheter has to be advanced into the ascending aorta.
  11. contrast dye is injected into the catheter and take some X-ray scans.
  12. The injection varies from 3 or 4 ml/sec through a catheter positioned
    distally to 10 ml/sec through a proximally positioned catheter.
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7
Q

During the direct brachial angio, where will be the incision made?

A

antecubital fossa

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8
Q

Complications during/after upper limb arteriography

A
  • Involuntary movement on the part of the arterial injection of the contrast media
  • Complications caused by the neurotoxic effect of contrast media
  • Bleeding at the puncture site
  • injury of the intima
  • a pseudo-aneurysm or - A-V fistula at the puncture site
  • thrombosis
  • impaired circulation
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9
Q

Clinical indications of lower limb arteriography

A
  • Chronic Ischemia (intermittent claudication, rest pain and ulceration)
  • Acute Ischemia
  • Peripheral Arterial Disease
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10
Q

Contraindications of lower limb arteriography

A
  • Patient history of severe or anaphylactic reaction to iodinated contrast
  • Patients with renal disease (eGFR < 50mL/min)
  • Severe anemia
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11
Q

approach of lower limb arteriography

A

femoral

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12
Q

DEVICES/EQUIPMENTS TO BE USED IN LOWER LIMB ARTERIOGRAPHY

A
  • Catheter: pigtail or straight
  • Syringe and needle
  • Fluoroscopy Machine
  • Local anesthetic
  • Guidewire
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13
Q

Contrast media used in lower limb arteriography

A

Use iso-osmolar contrast in
patients with critical ischemia. This reduces the pain/ heat associated with contrast injection

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14
Q

Complications in lower limb arteriography

A
  • Hemorrhage
  • Artery dissection
  • Bleeding and infection at the puncture site
  • Arterial thrombus
  • Guidewire breakage
  • Pseudoaneuryms
  • Allergic reaction to contrast media
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15
Q

clinical indications during upper limb venography

A
  • Edema
  • demonstrate the site of venous occlusion or stenosis
  • Superior vena cava obstruction
  • Congenital abnormality of the venous system
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16
Q

Contraindications of upper limb venography

A
  • Contrast media allergy
  • Impaired renal function
  • Severe anemia
17
Q

approach to upper limb venography

A

superficial vein at the elbow or wrist.

18
Q

devices used in upper limb venography

A
  • Fluoroscopy unit with spot film device
  • 18G butterfly needle
  • Tourniquet
19
Q

contrast media used in upper limb venography

A

Low / Iso-osmolar contrast medium.

20
Q

complications during upper limb venography

A
  • Due to the contrast medium
  • Pain, redness, or swelling at the injection site
  • Bleeding or other drainages from the injection site
21
Q

clinical indications of lower limb venography

A
  • Due to the contrast medium
  • Pain, redness, or swelling at the injection site
  • Bleeding or other drainage from the injection site
22
Q

Contraindications of lower limb venography

A
  • Patient history of severe or anaphylactic reaction to iodinated contrast
  • Patients with renal disease
  • Local sepsis
23
Q

Approach to lower limb venography

A

superficial vein in the foot

24
Q

Devices used in lower limb venography

A
  • Tilting radiography table.
  • Automatic Injector ( If available )
  • Tourniquet
  • Fluoroscopy unit with real time television monitor
  • 19g butterfly needle
25
Q

contrast media used in lower limb venography

A

Low osmolar contrast material (LOCM)

26
Q

how many images are obtained in lower limb venography?

A

12

27
Q

complications during lower limb venography

A
  1. Allergic reaction
  2. Tissue necrosis due to extravasation of contrast medium.
  3. Cardiac arrhythmia
  4. Haematoma
  5. Pulmonary embolus

INTERVENTIONAL RADIOLOGY (14 decks)

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