Angiography<br />Karar haider abd al hussein<br /> INDICATIONS<br />1. Primary vascular diseases like :<br />(a) Vasa-occlusive deseases.<br />(b) Vasospastic disease.<br />(c) Aneurysms.<br />(d) AVM Arteriovenous Malformations.<br />(e) AVF Arteriovenous Fistulas.<br />2. Vascularity assessment of a tumour.<br />3. Investigating source of haemorrhage.<br />4. Congenital vascular condition.<br />E.g.: coarctation, abnormal origin of vessels etc.<br />5. Pre-operative definition of vascular anatomy.<br />E.g. : Organ transplantation, Vascular tumour excision.<br />6. Percutaneous interventional vascular procedures.<br /><br />CONTRAINDICATIONS <br />1. Bleeding tendencies or anticoagulant therapy leading to a<br />prothrombin time above 30% of the control values.<br />2. Pulse not palpable at the vascular access site.<br />3. Thrombogenic tendency.<br />4. Skin infections or swelling at site of entry. In case of this, alternate<br />entry site is selected.<br />5. Abnormal renal function. If patient is in CRF then it is better to<br />put the patient on dialysis after doing the angiogram.<br />6. Cardio Vascular diseases like recent MI, overt CCF. Contrast<br />injection may exacerbate cardiac failure.<br />7. Hepatic failure.<br />8. History of allergy, skin rashes or asthma.<br />9. Pregnancy. <br />10. Residual barium from previous studies.<br /><br />PATIENT PREPARATION AND PRECAUTIONS <br />1. Careful history and clinical examination.<br />2. Informed consent.<br />3. Patient should be well hydrated.<br />4. Fasting 4 hours prior to procedure.<br />5. Shave and clean the arterial puncture !':>ite.<br />6. Xylocaine sensitivity test.<br />7. Following investigations to be done :<br />• Hb% and Haematocrit and platelet count<br />• ESR<br />• PT, PTT, BT and CT<br />• HBsAg and HN<br />• Pulse chart<br />• General examination and bruits, if any, should be noted<br />• If patient is on Warfarin, it should be stopped 4-6 days before<br />procedure<br />