d. Selective Catheterization or Direct Angiocardiography.
Patient preparation has been covered earlier in this section.
(a) Immediately after completion of cardiac catheterization, the patient
is positioned for exposure of the angiocardiographic films.
(b) The stopcock complex is readjusted so that the contrast medium
will flow from the previously filled syringe through the lumen of the catheter. Any
equipment previously used for cardiac catheterization and not needed for this procedure
will be disconnected and moved out of the way.
(c) Injection of the contrast medium and radiography are essentially
the same as for intravenous angiocardiography with the execution of the exposure-
timing phase being somewhat more critical. However, this difficulty is usually overcome
by the use of an automatic injection device and a serial film changer.
3-23. ABDOMINAL ANGIOGRAPHY
a. Aortography, Translumbar Percutaneous (Direct) Method. See figure
(1) Preparation. Patient preparation and administration of sensitivity test.
This has been covered earlier in this section. Digital subtraction is used to demonstrate
any part of the lower extremity.
(a) A sterile layout consisting of the necessary instruments and
materials is prepared.
The X-Ray table is adjusted in the horizontal position.
(c) The patient is placed in the prone position on the x-ray table. An
abdominal film (14x17-inch) is exposed and immediately developed. This film serves to
check the adequacy of the pre-examination preparation of the patient's bowels, the most
favorable centering of the film with respect to the area under examination, and the
correctness of the technique factors.
(d) If the vascular structures in the pelvic region are to be studied, the
examiner may request that sphygmomanometer cuff be adjusted around the proximal
portion of both thighs and inflated to about 200 mm (millimeters) Hg (mercury).