Name of the Procedure:

Non-selective Catheter Placement, Thoracic Aorta with Angiography of the Extracranial Carotid, Vertebral, and/or Intracranial Vessels (Unilateral or Bilateral) with Radiological Supervision

Summary

This procedure involves inserting a catheter into the thoracic aorta to perform angiography, which captures detailed images of blood vessels in the brain and neck. It provides diagnostic information about the carotid, vertebral, and intracranial vessels.

Purpose

The procedure aims to diagnose conditions affecting blood flow to the brain or neck, such as blockages or aneurysms. It helps doctors visualize blood vessels to ensure proper diagnosis and treatment plans.

Indications

• Symptoms like dizziness, strokes, or transient ischemic attacks (TIAs).
• Suspected blockage or irregularity in the carotid, vertebral, or intracranial arteries.
• Previously detected abnormalities that require detailed imaging.

Preparation

• Patients may need to fast for several hours before the procedure.
• Medication adjustments might be necessary, especially for blood thinners.
• Pre-procedure diagnostic tests like blood work or ECG might be required.

Procedure Description

1. The patient is prepped and usually lies on an X-ray table.
2. A local anesthetic is applied to numb the insertion site, typically in the groin.
3. A catheter is inserted into the thoracic aorta through an artery.
4. Contrast dye is injected through the catheter to highlight blood vessels.
5. X-rays or fluoroscopy capture detailed images.
6. The catheter is removed, and pressure is applied to the insertion site to prevent bleeding.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

It is performed in a hospital radiology suite or a specialized catheterization laboratory.

Personnel

• Interventional radiologist or vascular surgeon.
• Radiology technologists.
• Nurses.
• Anesthesiologist, if sedation is used.

Risks and Complications

• Common: Minor bleeding or bruising at the insertion site.
• Rare: Allergic reaction to contrast dye, infection, vascular damage, or stroke.
• Management: Immediate care for any complications, including medications or further procedures if necessary.

Benefits

• Provides detailed images to diagnose vascular issues accurately.
• Facilitates appropriate and timely treatment planning.
• Immediate visualization helps in urgent cases.

Recovery

• Patients typically remain in a recovery area for a few hours post-procedure.
• Instructions may include rest, hydration, and monitoring the insertion site.
• Most patients can return to normal activities within a day but avoid strenuous activities for a few days.
• Follow-up appointments as necessary.

Alternatives

• Non-invasive imaging techniques such as MRI or CT angiography.
• Pros: Less risk and no need for catheter insertion.
• Cons: May not provide images as detailed as conventional angiography.

Patient Experience

• Patients might feel slight pressure during catheter insertion.
• Sedation or a local anesthetic minimizes discomfort.
• Post-procedure, some soreness at the insertion site is common.
• Pain management includes over-the-counter pain relievers and comfort measures like rest and ice packs.