Cerebral Angiography and Pulmonary Angiography

Question 1

Is the radiologic and angiographic examination of the blood vessels of the brain.

Introduced by?

Answer 1

Cerebral Angiography, Egas Moniz in 1927

Question 2

Transit time of the cerebral circulation is only _______.

Answer 2

3 seconds

Question 3

The time between the points of maximum concentration.

Normal mean value of a cartoid siphon and in the parietal veins is 4.13 seconds

Answer 3

Cerebral circulation

Question 4

Cerebral Angiography

Clinical Indications

Answer 4

1.)Intracerebral and subarachnoid hemorrhage
2. Aneurysms presenting as space-occupying lesions
3. Brain arteriovenous shunts, carotico-cavernous fistulas (direct and indirect)
4. Cerebral ischemia both of extracranial and intracranial origin
5. Pre-operative assessment of intracranial tumours.

1. Patients with unstable neurology (usually following
   subarachnoid hemorrhage or stroke)
2. Patients unsuitable for surgery
3. Patients in whom vascular access would be impossible or relatively risky.99
4. Iodine allergy. Relative contraindication as angiography could be performe9d with gadolinium chelates.

Question 5

Cerebral angiography is most commonly performed from a?

Answer 5

Transfemoral approach; however, a brachial or axillary artery approach can be employed

Question 6

Cerebral Angiography

Equipment

Answer 6

Bi-plane imaging DSA, 3D Rotational Angiography

Question 7

A single or biplane digital subtraction
angiography apparatus is required,
with a C-arm allowing unlimited
imaging planes, high quality
fluoroscopy, and road-mapping facility.

Answer 7

Bi-plane imaging DSA

Question 8

Three-dimensional rotational
angiography is now increasingly
available and forms an important part
of the analysis of aneurysms during
treatment

Answer 8

3D Rotational Angiography

Question 9

Cerebra Angiography

Contrast Media

Answer 9

Non-ionic monomer, e.g. iohexol, iopamidol. The concentration required is equipment-dependent, but with modern DSA, 150 g Iml -1 will be suitable.

Question 10

Contrast Media Volume

Answer 10

1. Common carotid –10ml by hand in about 1.5–2 s
2. Internal carotid – 7ml by hand in about 1.5 s
3. Vertebral artery – 7ml by hand in about 1.5 s, but this volume can be diluted by 2ml of saline to opacify the contralateral vertebral on the same injection.

Question 11

Cerebral Angiography

Complications

Answer 11

Allergic reaction to the contrast dye

Blood clot or bleeding where the catheter is inserted, which could partly block blood flow to the leg

Damage to an artery or artery wall from the catheter, which
can block blood flow and cause a stroke (rare)

Damage to the kidneys from the IV contrast

Question 12

Cerebral Angiography

After Care

Answer 12

1. Standard nursing care for the arterial puncture site
2. Most departments adopt the practice of maintaining neurological observation for a period of 4 h or so after the procedure
3. Good hydration should be maintained.

Question 13

_________ permits visualization of the pulmonary vasculature.

Answer 13

Pulmonary Angiography

Question 14

The main pulmonary artery
arises from the _______.

Answer 14

Conus of the right ventricle

Question 15

Pulmonary Angiographhy

Equipment

Answer 15

5F sheath

3-mm J-guidewire

5F 90–100-cm-long pigtail catheter

Terumo wire

ECG monitoring and pressure kit required..

Question 16

Two commonly used catheters for pulmonary angiography

Answer 16

7-Fr APC
(left) and 7-Fr MONT 1 (right)

Question 17

After care of Pulmonary Angiography

Answer 17

Drink plenty of water – this helps to flush the dye from your body

Avoid strenuous exercise – for at least few days

Avoid a hot bath or shower – for at least few days

Check your puncture site regularly – keep an eye out for any bleeding, pain or swelling. In the days after your pulmonary angiogram, it is important to: If you notice a fever, redness, swelling, bleeding, pain, numbness or tingling in your arm and leg, call your doctor.