cerebral ANGIOGRAPHY
CEREBRAL angiography
CARDIOPULMONARY RESUSCITATION (CPR)
A radiological study of blood - Is an emergency procedure performed
in an effort to manually preserve intact
Bessel in the body after the brain function/provide adequate blood
introduction of iodinated circulation until further measures are
contrast media. taken to restore spontaneous blood
circulation and breathing in a person in
cardiac arrest.
1. DSA – DIGITAL SUBTRACTION
3. CT angio: main drawbacks are contrast use
ANGIOGRAPHY: gold standard
and radiation exposure.
o Invasive and risk of nephrotoxic
o Calcifications are overestimated
contrast, ionizing radiation
o Preferred for aorta and coronaries.
2. Vascular ultrasound
4. MRA: non invasive, no radiation exposure.
o Least invasive, can be done bedside,
o Preferred for carotids and
cost effective.
intracranial vessels as MRI brain can
o Best choice for imaging vessels close
also be obtained.
to skin surface.
o Widely used in neurological
Drawback
disorders.
o Limited anatomic coverage, deep
vessels can’t be imaged, operator
dependent, requires skill.
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EQUIPMENTS
Catheters Surgical blade
Arterial sheath Saline
Medicut Disposable syringes
Guidewires Local anesthesia
Contrast Heparin
Connector/100 cm tubing Surgical gloves
Elastroplast
Preparation
1. Nil orally 4-6 hrs
2. On trolley
3. In hospital gown
4. Groin shave
5. Records
6. Should be well hydrated
7. Should void before procedure
8. Peripheral pulses marked
9. IV line in place
10. Informed consent
Procedure
1. Gaining arterial access 6. Hard copy
2. Selective arterial catheterization 7. Patient may be sedated to reduced anxiety
3. Image acquisition 8. Monitor of vital signs
4. Closure of arterial access. 9. Local anesthetic is usually used in the area where the
5. Post processing catheter is to be inserted.
10. Most common femoral artery
1. Small incision given, medicut is inserted into the artery.
2. Fluoroscopy is used to guide the needle to the proper position
3. Needle is then removed after placing guide wire in the artery and vascular sheath is inserted over the guide wire.
4. Catheter is then inserted along the guide wire through the sheath.
5. When the catheter is in the correct position, the wire is pulled out and dye is injected through the catheter.
6. Images are acquired during contrast injection.
7. Injections can be made directly into the artery of interest (selective arteriography).
Post Procedural Care
1. After the catheter is removed compression is applied to the puncture site.
2. Bes rest for minimum of 4 hrs
3. During the rest, patient is monitored and vital sign like peripheral pulse like distal to puncture are regularly.
4. Extremity is also checked for warmth, color numbness to ensure circulation has not been disrupted.
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