Download Free Medical Interventional Radiology and Angiography PowerPoint Presentation

Interventional Radiology and Angiography PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Check out this medical presentation on Angiography, which is titled "Interventional Radiology & Angiography", to know about interventional radiology and angiography.

Tags : Angiography, Interventional Radiology

Published on : May 25, 2021 | Views : 3047 | Downloads : 18

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

DR. Walid Asaad, MBBS, MD, DABR,CAQ Diagnostic &Interventional Radiology King Abdulaziz University Hospital INTERVENTIONAL RADIOLOGY & ANGIOGRAPHY
Slide 2-

INTERVENTIONAL RADIOLOGY A subspecialty which provides minimally invasive techniques with the help of imaging modalities to diagnose or treat a condition. Minimally invasive Local anesthesia Early recovery
Slide 3-

8 out of 10 procedures use skin incisions smaller than 5 mm. 9 out of 10 procedures use only local anaesthetic, sometimes with sedation. Up to 8 out of 10 patients go home the same day
Slide 4-

INTERVENTIONAL RADIOLOGY Stent placement Embolization Thrombolysis Balloon angioplasty Atherectomy Electrophysiology
Slide 5-

Percutaneous biopsy Abscess drainage Percutaneous nephrostomy Percutaneous Biliary drainage Radiofrequency ablation
Slide 6-

ANGIOGRAPHY The radiologic examination of vessels after the introduction of a contrast medium.
Slide 7-

HISTORY The first angiogram was performed only months after Roentgen's discovery of X rays. Which was when? Two physicians injected mercury salts into an amputated hand and created an image of the arteries
Slide 8-

Post mortem injection of mercury salts in Jan,1896.
Slide 9-

Interventional radiologic procedures began in 1930s with angiography. In early 1960s Mason Jones pioneered transbrachial selective coronary angiography. Later in 1960s transfemoral angiography was developed.
Slide 10-

BASIC PRINCIPLES Arterial access In 1953 Seldinger described a method for catheterization of vessels. A percutaneous technique for arterial and venous access. Femoral artery is most commonly used.
Slide 11-

SELDINGER TECHNIQUE Seldinger needle. 18gauge single use,sterile needle. 2 parts-- a solid inner needle(stylet) & an outer thin wall needle for smooth passage. a hub---good instrument balance winged handle---good control.
Slide 12-

ppt slide no 12 content not found
Slide 13-

ppt slide no 13 content not found
Slide 14-

Site cleaned, area draped, local anesthetic given. The seldinger needle is introduced into the artery. When pulsating blood returns, the stylet is removed.
Slide 15-

A guide wire is inserted through the needle. With guide wire in vessel, needle is removed. Catheter is threaded onto the guide wire. Under fluoro, the catheter is then advanced and the guide wire is removed.
Slide 16-

ppt slide no 16 content not found
Slide 17-

GUIDEWIRES Guide the catheter. Allow safe introduction of catheter into the vessel. Made of stainless steel. Usually about 145cm long An inner core wire that is tapered at the end to a soft flexible tip.
Slide 18-

Covered by a coating—teflon, heparin and recently hydrophilic polymers(glide wires) are used. Coating reduces friction, gives strength to GW. Tips at the end of GW Straight J- tipped—prevents subintimal dissection of artery.
Slide 19-

ppt slide no 19 content not found
Slide 20-

ppt slide no 20 content not found
Slide 21-

ppt slide no 21 content not found
Slide 22-

CATHETERS Many shapes and sizes. diameter is given in French(Fr)—3Fr=1mm. Straight- end hole only—smaller vessels/minimal contrast. Pigtail- circular tip with multiple side holes —larger vessels/ more contrast.
Slide 23-

H1 or Head hunter tip– used for femoral approach to brachiocephalic vessels. Simmons catheter is highly curved --- for sharply angled vessels--cerebral and visceral angiography. C2 or Cobra catheter has angled tip joined to a gentle curve—celiac, renal & mesenteric arteries.
Slide 24-

ppt slide no 24 content not found
Slide 25-

Judkins catheters Right(lesser curve) & left(greater curve) for right & left coronary arteries. Amplatz catheters Right & left coronary arteries
Slide 26-

ppt slide no 26 content not found
Slide 27-

ppt slide no 27 content not found
Slide 28-

Contrast Media Initially ionic iodine compounds were used. Now non ionic contrast media in practice—low adverse reactions and low physiologic problems.
Slide 29-

INDICATIONS Diagnosis & presence of ischemic heart disease. After revascularization procedures Congenital heart lesions & anomalies of great vessels. Valve disease, myocardial disease & ventricular function.
Slide 30-

Atheroma Aneurysms Arteriovenous malformations Arterial ischemia Trauma
Slide 31-

Patient preparation Explain procedure & risk to the patient. History & physical examination. Lab tests. Consent Pre procedure I/V fluids. Medication to relieve anxiety.
Slide 32-

Monitoring during and after procedure ECG, Automatic BP measurement & pulse oximetry. Life saving drugs and equipments. Immobile for minimum 4hrs after. Vital signs monitored. Puncture site inspected.
Slide 33-

Contra-indications Contrast allergy Impaired renal function Blood- clotting disorders Anti coagulant medication Unstable cardio pulmonary/ neurological status
Slide 34-

Risks Bleeding at puncture site Thrombus formation Embolus formation –plaque dislodged from vessel wall by catheter Dissection of vessel Puncture site infection ( contaminated sterile field) Contrast reaction
Slide 35-

INTERVENTIONAL RADIOLOGY SUITE Specifically designed to accommodate the quantity of equipment needed & the large number of people involved in the procedure.
Slide 36-

Interventional radiology suite Procedure Room Room size- 400-600 square feet Easily cleaned (floors, wall, etc.) Outlets needed for O2, suction. At least three means of access. Control Room 100-150 square feet Easy access and communication to procedure room Operating console with Computers, monitors .
Slide 37-

EQUIPMENTS The X-ray apparatus for interventional radiology is more massive,flexible,expensive & advanced. More heat load and serial images.
Slide 38-

ppt slide no 38 content not found
Slide 39-

X RAY TUBE Two ceiling track-mounted X-ray tubes alongwith an image intensified fluoroscope mounted on C or an L arm. A large diameter massive anode disc(15cm diameter, 5cm thick) to accommodate heat load. Cathodes designed for magnification & serial radiography.
Slide 40-

A large focal spot of 1mm for heat load. A small focal spot( no more than 0.3mm) is necessary for spatial resolution of small vessel magnification.
Slide 41-

Power rating of 80kW—for rapid sequence serial radiography. Anode heat capacity of 1 MHU—to accommodate heat load.
Slide 42-

Generators High frequency and high voltage generators Three phase,12 pulse power.
Slide 43-

Patient couch Stationary couch with a floating,tilting or rotating table top. Controls for couch positioning are located on side of table and also on a floor switch. May also have a computer controlled stepping capability.
Slide 44-

Image receptor 2 different types. Cinefluorographic camera—now obsolete. Nowadays Digital image receptors are used with a television camera pickup tube or a charge-coupled device(CCD).
Slide 45-

THANKS