Angiogram

After a baseline angiogram confirms the presence and location of the vascular occlusion, a microcatheter is navigated over a microwire into the occluded vessel, traversing the thrombus. Once the microcatheter is positioned immediately distal to the clot, thrombolytic infusion begins the microcatheter is then pulled back through the clot while dmg is infused. Dose adjustments and total dose calculations are made depending on the clinical circumstances, pretreatment dose of rt-PA received, degree of recanalization, and relative size and function of the territory at risk. 

FIGURE 4.2 (Continued) A compliant balloon was used to perform angioplasty (c). Postangioplasty angiogram demonstrated complete recanalization of the basilar artery and its major branches (d and e). MRI performed 2 days later demonstrated only small areas of infarction in the cerebellar hemispheres (arrows—f and g) but no brainstem or occipital infarcts. 

For patients who demonstrate continued neurological deterioration despite anticoagulation, local intrathrombus thrombolysis may be beneficial. In case series in which most patients received urokinase, favorable outcome with no major therapeutic morbidity has been described.In one study, 29 patients with angiogram-proven CVST were reviewed retrospectively. Of the 18 who received local urokinase, 17 recovered completely, and 1 was left with a mild neurological deficit. Heparin was given to four patients, three of whom made a complete recovery. Six presented in a comatose state with severe CVST and only supportive measures were used. It is difficult to draw conclusions from these data, as only patients with mild or moderately severe disease were selected for thrombolytic treatment. 

Percutaneous coronary intervention A minimally invasive procedure whereby access to the coronary arteries is obtained through the femoral artery up the aorta to the coronary os. Contrast media is used to visualize the coronary artery stenosis using a coronary angiogram. A guidewire is used to cross the stenosis and a small balloon is inflated and/or stent is deployed to break up atherosclerotic plaque and restore coronary artery blood flow. The stent is left in place to prevent acute closure and restenosis of the coronary artery. Newer stents are coated with antiproliferative drugs, such as paclitaxel and sirolimus, which further reduce the risk of restenosis of the coronary artery. 

Nowak-Sliwinska, P., Ballini, J. P., Wagnieres, G. 8c van den Bergh, H. Processing of fluorescence angiograms for the quantification of vascular effects induced by anti-angiogenic agents in the CAM model. Microvasc. Res. 79, 21-28 (2010). 

Figure 1. Radionuclide angiogram recorded with Ir-191m.

Acute sialadenitis ( iodide mumps ) has been described in a 70-year-old man who underwent femoral artery angiography with an iodine-containing contrast agent he gave a history of a similar episode 24 hours after a previous angiogram (56). 

Yang EH, Lerman A. Angina pectoris with a normal coronary angiogram. Herz. 2005 30 17-25. 

The blood vessel in the lower left hand portion of this angiogram is made of synthetic material. (Simon Fraser/ Freeman Flospital/Photo Researchers, Inc.)... 

The primary endpoint was a composite of death, Ml, or unplanned revascularization for ischemia plus major bleeding. The time from drug administration to angiogram was 5.3 hours. 

I Angiogram one month after excision femoral artery and application... 

All patients were asked to return to the investigative site for a clinical visit four weeks one-week postprocedure to repeat clinical labs and monitor acute clinical events. All patients were contacted by telephone by the investigative site at three months one week for a safety evaluation. All subjects were required to return to the investigative site for a repeat coronary angiography whether they were experiencing symptoms or not. If a patient had a positive exercise stress test at any time up to and including his required follow-up, a repeat angiogram was performed. 

Gibson et al. used the technique of corrected TIM I frame counts from the angiogram of patients with acute myocardial... 

Contrast media (CM) are used to enhance visualization during diagnostic angiograms and to guide percutaneous coronary interventions (PCI). The increased use of PCI led to the increased number of patients receiving CM (1,2). However, use of CM is not without risks. Although some complications associated with CM are mild and transient, such as discomfort and itching, others are more serious such as anaphylaxis, hypotension, cardiovascular events, and renal dysfunction (I-3). 

Eliasziw M, Smith RE Singh N, Holdsworth DW, Fox AJ, Barnett HJ. Further comments on the measurement of carotid stenosis from angiograms. North American Symptomatic Carotid Endarterectomy Trial (NASCET) Group. Stroke 1994 25 2445-2449. 

Left) Angiogram of infrarenal abdominal aortic aneurysms (AAA) with marker catheter in place (Right) 3D CT reconstruction of an infrarenal AAA. 

Endoleaks are a major concern for those engaged in EVAR (Table 3, Fig. 4). This phenomenon describes the continuation of blood flow into the extragraft portion of the aneurysm (20). Endoleaks are related to the graft itself or other factors such as the presence of large patent lumbar arteries (21). The presence of an endoleak increases the chance of rupture. Diagnostic imaging plays an important role in the detection of endoleaks intraprocedural angiograms, surveillance CT scans, or duplex ultrasounds. 

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