Name of the Procedure:

Aortography, abdominal plus bilateral iliofemoral lower extremity (Catheter by serialography, radiological supervision, and interpretation)

Summary

Aortography is an imaging test used to visualize the arteries in the abdomen and the lower extremities. It involves the insertion of a catheter and the injection of a contrast dye, followed by taking a series of X-ray images to identify any blockages or abnormalities in the blood vessels.

Purpose

• Medical Condition: To diagnose conditions such as atherosclerosis, aneurysms, blockages, or other vascular abnormalities.
• Goals/Outcomes: To provide a detailed map of the arterial system to help plan treatments such as surgery or angioplasty.

Indications

• Symptoms such as leg pain, claudication (pain due to inadequate blood flow), or ulcers.
• Predisposing conditions like diabetes or peripheral artery disease (PAD).
• Prior inconclusive imaging results necessitating further investigation.

Preparation

• Fasting: Patients are usually required to fast for 6-8 hours before the procedure.
• Medication Adjustments: Patients may need to adjust or discontinue certain medications, particularly blood thinners.
• Pre-procedure Tests: Routine blood tests, ECG, and imaging tests like ultrasound or CT angiography may be required.

Procedure Description

1. Insertion: The patient is positioned on the X-ray table and an area in the groin is cleaned and numbed with a local anesthetic.
2. Catheterization: A thin, flexible tube called a catheter is inserted into the artery and guided to the abdominal aorta.
3. Contrast Injection: A contrast dye is injected through the catheter.
4. Imaging: A series of X-ray images (serialography) are taken to visualize the arteries in detail.
5. Completion: The catheter is removed, and pressure is applied to the entry site to prevent bleeding.

Tools/Equipment: Catheter, contrast dye, X-ray machine. Anesthesia: Typically, local anesthesia is used. In some cases, mild sedation may be offered.

Duration

The procedure typically takes about 1-2 hours.

Setting

Usually performed in a hospital or specialized outpatient radiology clinic.

Personnel

• Interventional Radiologist
• Radiology Technician
• Nurse
• Occasionally an Anesthesiologist if sedation is required

Risks and Complications

• Common Risks: Pain or bruising at the catheter insertion site, allergic reaction to contrast dye.
• Rare Risks: Damage to the blood vessels, kidney problems (due to contrast dye), infection, or bleeding complications.

Benefits

• Expected Benefits: Accurate diagnosis of vascular conditions, detailed arterial mapping.
• Realization Time: Immediate availability of results for planning further treatment.

Recovery

• Post-procedure Care: Patients are usually monitored for a few hours for any immediate complications.
• Recovery Time: Most patients can resume normal activities within a day.
• Instructions: Avoid strenuous activities for 24-48 hours; keep the insertion site clean and dry.

Alternatives

• Other Options: Non-invasive imaging tests like Doppler ultrasound, CT angiography, or MR angiography.
• Pros and Cons: Non-invasive methods avoid the risks associated with catheterization but may not provide as detailed images.

Patient Experience

• During the Procedure: Some discomfort from the insertion site; a warm sensation when the contrast dye is injected.
• After the Procedure: Mild soreness at the insertion site; if sedation was used, a groggy feeling that resolves within a few hours.
• Pain Management: Over-the-counter pain relievers can be taken if necessary.