ANGIOGRAPHY IN THE EVALUATION OF PATIENTS FOR ABDOMINAL AORTIC SURGERY

¹ Radiologist, New England Medical Center Hospitals and Associate Professor of Radiology, Tufts University School of Medicine.
² Fellow in Cardiovascular Radiology, New England Medical Center Hospitals and Tufts University School of Medicine.
³ Assistant in Surgery, New England Medical Center Hospitals and Assistant Professor of Surgery, Tufts University School of Medicine.
⁴ Chief of Vascular Service, New England Medical Center Hospitals and Professor of Surgery, Tufts University School of Medicine.

We have reviewed the angiographic findings in 288 patients with potential surgical diseases of the abdominal aorta. We find that serial aortography, carefully performed, is safe and accurate. Retrograde femoral catheterization is preferred when feasible.

In occlusive disease, the aortogram precisely identifies the obstructed segment, and shows the condition of collateral and runoff vessels. In aortic stenosis, the measurement of a pressure gradient is a valuable addition in interpreting the significance of lesions roentgenographically shown. Postoperatively, the aortogram permits early detection of complications.

In patients with aneurysms, the size, shape and location of the lesion, and the condition of other arteries shown by arteriography help make the decision whether to operate in borderline cases. Diffuse ectasia can readily be differentiated from aneurysm. When a leaking aneurysm is suspected, an emergency aortography is indicated if the patient is not in shock.

The freer use of arteriography in aortic disease helps in planning surgery or medical management, and also permits us to learn more about the disease processes to improve our future judgment.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?