Name of the Procedure:

Aortography, Thoracic, by Serialography, Radiological Supervision and Interpretation

Summary

Aortography is an imaging procedure that uses X-rays to visualize the thoracic (chest) section of the aorta, the main artery that carries blood from the heart to the rest of the body. By employing serialography, a series of detailed images are captured, allowing for thorough examination and diagnosis.

Purpose

Aortography helps diagnose problems in the thoracic aorta such as aneurysms, dissections, or blockages. The goal is to create precise images to guide treatment decisions or surgical planning.

Indications

• Persistent chest pain suspected to be related to aortic issues
• Congenital or acquired aortic abnormalities
• Trauma causing potential aortic damage
• Pre-surgical mapping for planned interventions on the aorta

Preparation

• Patients may be asked to fast for 6-8 hours before the procedure.
• Medications may need to be adjusted or paused as advised by the physician.
• Blood tests and imaging studies such as an echocardiogram may be required beforehand.

Procedure Description

1. The patient is positioned on an X-ray table.
2. Local anesthesia is applied to the groin or arm where a catheter will be inserted.
3. A thin, flexible catheter is guided through the blood vessels to the aorta.
4. A contrast dye is injected through the catheter to highlight the aorta on X-ray images.
5. Serial X-ray images are taken to obtain detailed views.
6. The radiologist supervises and interprets the images to identify any abnormalities.
7. After imaging, the catheter is removed, and pressure is applied to prevent bleeding.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Aortography is performed in a hospital's radiology or catheterization lab.

Personnel

• Interventional radiologist or cardiologist performing the procedure
• Radiologic technologists assisting with imaging
• Nurses monitoring patient vital signs and comfort
• Anesthesiologist or sedation specialist if deeper sedation is required

Risks and Complications

• Allergic reaction to contrast dye
• Bleeding or infection at the catheter insertion site
• Blood vessel damage
• Kidney dysfunction due to contrast dye
• Rarely, stroke or heart attack

Benefits

• Accurate diagnosis leading to effective treatment
• Detailed imaging aiding in surgical planning
• Immediate results interpreted by a radiologist

Recovery

• Patients are monitored for several hours post-procedure.
• Instructions include keeping the insertion site clean and dry.
• Avoid heavy lifting and strenuous activities for a few days.
• Follow-up appointments may be scheduled to review results and plan further treatment.

Alternatives

• Magnetic Resonance Angiography (MRA): A non-invasive imaging technique with no exposure to radiation, though it may not provide as detailed images as serialography.
• Computed Tomography Angiography (CTA): Offers detailed images, but also involves radiation exposure and possible contrast dye risks.
• Ultrasound: Limited to certain areas and may not provide comprehensive aortic imaging.

Patient Experience

During the procedure, the patient may feel a warm sensation as the dye is injected. Mild pressure or discomfort at the catheter site is common. Post-procedure, managing discomfort might involve over-the-counter pain relief. Rest and hydration are recommended to aid recovery.