CLINICAL STUDIES ON SELECTIVE ANGIOGRAPHY IN UROLOGY
PART I. METHODOLOGY AND NORMAL RADIOGRAM OF SERIAL SELECTIVE RENAL AND INTERNAL ILIAC ANGIOGRAPHY
1964 Volume 55 Issue 12 Pages 1311-1330
Details
1964 Volume 55 Issue 12 Pages 1311-1330
1. According to Seldinger's method, serial selective renal and internal iliac angiography were performed inserting green catheter (Kifa Co. Sweden) or medium sized catheter (B-D Co. U. S. A.) through the femoral artery.
2. Injections were made with 6-8ml. of contrast medium by hand, and 30ml. by automatic injector with the pressure of 3 Kg/cm2, into the renal and internal iliac artery respectively. The contrast medium used was 60% Urografin (Renographin) or 60% Conrey.
3. In renal angiography factors unfavorable to insert catheter into the renal artery was the tortuasity and stricture of the artery. Four centimeters of the catheter's tip was convexed drawing an arc with the diameter of 3cm., considering the diameter of the aorta and the angle of the origin of the renal artery.
4. Less valuable was selective angiography of the kidney with multiple arterial supply. These were found 11% on right and 17% on left.
5. Arterial branch which usually supplies upper portion of the kidney initiates from the origin of the renal artery. (12% on right, and 180 on left).
6. These evidences suggest the necessity of performing the general aortography together with this selective angiography.
7. In selective internal iliac angiography, bilateral femoral arteries were catheterized simultaneously and the insertion of the catheters was then attempted into the contra lateral iliac artery beyond the aortic bifurcation.
8. Failure of this technique was approximately 15% when the iliac arteries were so tortuous.
9. This new technique is favorable in visualizing peripheral vesical arteries and in observing the changes of the bladder wall in the capillary phase.
10. Complications of this procedure are avoidable with suitable preoperative care and careful manipulation.
11. In discussion, the authors stressed the prevalence of selective aegiography in the differential diagnosis and the therapeutical indications. The pathological radiogram will be presented in the next paper.
