Name of the Procedure:

Aortography, thoracic, without serialography, radiological supervision and interpretation

Summary

Aortography is a medical imaging technique used to visualize the thoracic section of the aorta, the large blood vessel that carries blood from the heart to the rest of the body. This procedure uses X-ray imaging without the need for continuous series of images (serialography), with a radiologist guiding and interpreting the images.

Purpose

Aortography is used to identify and assess conditions related to the aorta, such as aneurysms, dissections, or blockages. The goal is to provide a clear image of the thoracic aorta to aid in diagnosis and guide treatment planning.

Indications

• Suspected aortic aneurysm or dissection
• Trauma to the chest area
• Unexplained chest pain or back pain
• Monitoring of known aortic diseases
• Pre-surgical evaluation for aortic or cardiac surgery

Preparation

• Patients may be required to fast for several hours before the procedure.
• Blood tests and kidney function tests may be conducted to ensure safety.
• Medications may need to be adjusted or temporarily stopped.
• The patient should inform the doctor of any allergies, especially to contrast material.

Procedure Description

1. The patient is positioned on an X-ray table.
2. A local anesthetic is administered to numb the insertion site, typically in the groin.
3. A catheter is inserted into a blood vessel and guided to the thoracic aorta using fluoroscopy (real-time X-ray).
4. Contrast material is injected through the catheter to enhance the X-ray images.
5. X-ray images are taken to visualize the aorta.
6. The catheter is removed, and pressure is applied to the insertion site to prevent bleeding.

Duration

The procedure typically takes between 30 minutes to 1 hour.

Setting

The procedure is performed in a hospital's radiology department or an outpatient imaging center.

Personnel

• Radiologist
• Radiologic technologists
• Nurses
• Possibly a cardiologist or vascular surgeon

Risks and Complications

• Allergic reaction to contrast material
• Bleeding or infection at the catheter insertion site
• Damage to blood vessels
• Kidney damage from the contrast material
• Rarely, stroke or heart attack

Benefits

• Accurate diagnosis of aortic conditions
• Detailed images to guide surgical or medical treatment
• Minimally invasive compared to surgical exploratory procedures
• Immediate results for quick decision-making

Recovery

• Patients are usually monitored for a few hours after the procedure.
• Instructions will include avoiding strenuous activities for 24-48 hours.
• Keep the insertion site clean and dry.
• Follow-up appointments as necessary for results and further treatment planning.

Alternatives

• CT angiography - provides similar imaging but with a different technique.
• MRI Angiography - uses magnets and radio waves, suitable for patients allergic to contrast dye.
• Ultrasound - less invasive but may not provide as detailed images of the thoracic aorta.

Patient Experience

• Patients might feel pressure during catheter insertion and a warm sensation when the contrast material is injected.
• Typically, there is minimal pain during the procedure thanks to local anesthesia.
• Post-procedure discomfort is usually limited and managed with over-the-counter pain relief if necessary.