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Cardiology
Renal and Mesenteric Artery Angiography
Built from Cardiovascular Catheterization and Intervention: A Textbook of Coronary, Peripheral, and Structural Heart Disease
What’s inside
9 sections · 98 slides
Overview
- Scope of this topic
Anatomic considerations
- Embryology of the renal vasculature
- Origin of the renal arteries
- Course of the right and left renal arteries
- Accessory renal arteries
- Clinical impact of renal artery variants
- Accessory renal artery on selective angiography
- Anatomical Variations in Renal Arteries (RA)
- The mesenteric arteries
- Branches of the celiac trunk
- Gastric and gastroepiploic anastomoses
- Course of the superior mesenteric artery
- Branches of the superior mesenteric artery
- Inferior mesenteric artery and collaterals
- Superior and inferior mesenteric arterial territories
- Territories of the three visceral arteries
- Selective celiac trunk angiogram
Noninvasive imaging
- Duplex ultrasound for renal artery stenosis
- CT angiography and MR angiography
- Split renal function testing
- Noninvasive Imaging Modalities for Renal and Mesenteric Evaluation
Procedural fundamentals
- Vascular access routes
- Vascular Access Usage and Common Complications
- Contrast agents and dilution strategy
- Contrast Agents Used in Angiography
- Catheters for nonselective aortography
- Catheter selection by target and access
- Projections and digital optimisation
- Angulation for specific vessels
Indications
- Indications for renal angiography
- Selection Criteria for Renal Angiography
- When to image for mesenteric ischaemia
- Choosing angiography versus immediate surgery
- Clinical Indications for Mesenteric Angiography
Performing the study
- Nonselective abdominal aortography
- Injection protocol and the artery of Adamkiewicz
- Optimising the aortographic view
- Nonselective Abdominal Aortography
- Access and catheters for selective renal angiography
- Selective left renal angiogram with a Cobra catheter
- Commonly Used Catheters and Tips for Selective Renal Angiography
- Safe engagement of the renal ostium
- Embolisation risk and pressure damping
- Contrast injection and projections for renal arteries
- Sequence of a selective renal study
- Selective mesenteric angiography
- Selective superior and inferior mesenteric angiograms
- Commonly Used Catheters and Tips for Selective Mesenteric Angiography
- Wire technique for mesenteric engagement
- Projections for selective mesenteric angiography
Clinical aspects
- Renal artery stenosis: burden and associations
- Haemodynamic consequences of renal artery stenosis
- Management of atherosclerotic renal artery stenosis
- Fibromuscular dysplasia: definition and diagnosis
- String-of-beads appearance of fibromuscular dysplasia
- Epidemiology and associations of fibromuscular dysplasia
- Atherosclerosis versus fibromuscular dysplasia
- Pathophysiology of mesenteric ischaemia
- Acute mesenteric ischaemia
- Chronic mesenteric ischaemia
- Median arcuate ligament syndrome
- Visceral artery aneurysms: incidence and risk
- Splenic artery aneurysm
- Hepatic and pancreaticoduodenal aneurysms
- Celiac, mesenteric and renal artery aneurysms
- Renal artery aneurysm and rupture
- Renal artery rupture with contrast extravasation
- Coil embolisation of a ruptured renal artery
- Visceral and renal vasculitis
Invasive physiological assessment
- Limits of two-dimensional angiography
- Translesional pressure gradients
- Hyperaemic agents and renal fractional flow reserve
- Intravascular ultrasound in renal artery stenosis
- Criteria for Significant Renal Artery Stenosis (Ras) Based on Angiographic Severity and Physiologic Testing
Limitations and pitfalls
- Contrast-induced nephropathy
- Carbon dioxide angiography
- Accessory renal arteries as a technical challenge
- Accessory renal arteries and hypertension
- Procedural and operator-dependent limitations
- Summary of key points
- References (1 of 8)
- References (2 of 8)
- References (3 of 8)
- References (4 of 8)
- References (5 of 8)
- References (6 of 8)
- References (7 of 8)
- References (8 of 8)
- Cardiovascular Catheterization and Intervention: A Textbook of Coronary, Peripheral, and Structural Heart Disease
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