Name of the Procedure:

Aortography, abdominal, by serialography
Common name(s): Abdominal Aortography

Summary

Abdominal aortography is a procedure that uses X-rays to visualize the abdominal aorta, the main blood vessel supplying blood to the abdomen, pelvis, and legs. This is achieved through serialography, a technique involving a series of rapid X-ray images.

Purpose

Abdominal aortography is used to diagnose and evaluate conditions such as aneurysms, blockages, or other abnormalities in the abdominal aorta. The primary goal is to provide detailed images that help in planning appropriate medical or surgical treatments.

Indications

• Abdominal pain suspected to be related to vascular issues
• Symptoms suggesting an abdominal aortic aneurysm (AAA)
• Unexplained lower back pain
• Peripheral artery disease symptoms like leg pain or cramping
• Monitoring known aortic aneurysms or other vascular abnormalities

Preparation

• Patients are typically required to fast for 6-8 hours before the procedure.
• Blood tests may be performed to assess kidney function.
• Adjustments or temporary discontinuation of certain medications may be necessary, particularly blood thinners.
• An intravenous (IV) line will be placed to administer contrast dye and medications.

Procedure Description

1. The patient is positioned on the X-ray table, and local anesthesia is administered at the site of catheter insertion, usually in the groin.
2. A thin, flexible catheter is inserted into a blood vessel and guided to the abdominal aorta using live X-ray images (fluoroscopy).
3. Contrast dye is injected through the catheter, making the aorta visible on the X-rays.
4. A series of rapid images (serialography) are taken to capture the flow of contrast through the aorta and its branches.
5. The catheter is removed, pressure is applied to the insertion site to prevent bleeding, and a bandage is applied.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Abdominal aortography is usually performed in a hospital's radiology or specialized imaging department.

Personnel

• Interventional Radiologist
• Radiology Technician
• Nurses
• Anesthesiologist (if sedation is used)

Risks and Complications

• Allergic reactions to contrast dye
• Bleeding or infection at the catheter insertion site
• Blood vessel damage
• Kidney damage, especially in patients with pre-existing kidney conditions
• Rarely, blood clots or embolism

Benefits

The detailed images provided by abdominal aortography can help in accurately diagnosing vascular problems and guiding appropriate treatments. The benefits are often realized immediately as the information gathered can be used to make informed medical or surgical decisions.

Recovery

• Patients are usually monitored for a few hours post-procedure.
• Rest and restricted activities are advised for 24 to 48 hours.
• Follow-up appointments may be scheduled to discuss results and any necessary further treatment.
• Drinking plenty of fluids is encouraged to help flush out the contrast dye.

Alternatives

• Ultrasound: Non-invasive but less detailed for certain conditions.
• CT angiography: Less invasive but involves higher radiation dose.
• MRI angiography: Non-invasive and no radiation, but not suitable for all patients (e.g., those with metal implants or severe claustrophobia).

Patient Experience

During the procedure, the patient may feel pressure when the catheter is inserted and a warm sensation when the contrast dye is injected. Post-procedure discomfort is typically mild and can be managed with over-the-counter pain medication. Most patients can resume normal activities within a couple of days, following their doctor's instructions.