they had produced a radiograph showing the blood vessels of an amputated hand using Teichman’s mixture

first human cardiac catheterization

(1952) he announced a percutaneous method of catheter introduction.

(1974) he introduced the doubled-lumen, ballon tip catheters.

• refers to the opacification of vessels through injection of contrast media. • Radiologic examination of vascular structures within the body after introduction of contrast media.

TRUE OR FALSE ADVANTAGES OF IR • Minimally invasive • Reduce hospital stays in many patients. • Help some patients avoid surgery. • Reduce medical cost.

• fabricated of stainless steel and contain an inner core wire that is tapered at the end to a soft, flexible tip.

Interventional procedure for angiography

Interventional procedure for aortography

Interventional procedure for arteriography

Interventional procedure for cardiac catheterization

Interventional procedure for myelography

• The shaped tip of the catheter is required for selective catheterization of openings into specific arteries.

• designed by Vincent Hinck is used for the femoral approach to the brachiocephalic vessels.

• is highly curved for approach to sharply angled vessels and was also designed for cerebral angiography but was later adopted for visceral angiography.

• has an angled tip joined to a gentle curve and is used for introduction into celiac, renal, and mesenteric arteries.

• Have side holes for ejecting contrast media into a compact bolus.

• generally, is used to flush catheters.

Advantages of non-ionic contrast media

An 18 gauge hollow needle with a stylet

TRUE OR FALSE RISK OF ARTERIOGRAPHY • continued bleeding at the puncture site. • reaction to contrast media, • kidney failure. • serious adverse reactions related to blood clot formation or catheter. • guidewire penetrating injury.

• The procedure room itself should not be less than ______ ft along any wall and not less than ______ ft2. •should have at least three means of access.

• The control room should be large, perhaps _____ft2.

Focal spot size

Disc size

Power rating

Anode heat capacity

ANGIOGRAPHIC TEAM • interventional Radiologic Technologist • Radiology Nurse • Interventional Radiologist/Cardiologist • Nurse Tech/Med Tech • Echocardiographer • Anesthesiologist

TYPES OF ANGIOPLASTIES

• First a guide wire is passed through the narrowed area of a vessel. • Then a smaller catheter is passed over the guide wire through the stenosis to begin the dilation process. • Finally, a larger catheter is passed over the smaller catheter to cause further dilation.

• 1974 Gruentzig and Hopff introduced the double lumen, balloon tipped Catheter. • sizes ranging from 3 to 9 Fr, with attached balloons varying in length and expanding to diameters of 2 to 20 mm or more. • The balloon is usually inflated with a diluted contrast medium mixture for 15 to 45 seconds, depending on the degree of stenosis and the vessel being treated.

How can we determine the success of angioplasty? 1. Contrast medium can be injected 2. comparing transcatheter blood pressure measurements from a location distal and a location proximal to the lesion site. • In 1978, Molnar and Stockum described the use of balloon angioplasty for dilation of strictures within the biliary system. •Balloon angioplasty is also conducted in venous structures, ureters, and the gastrointestinal tract. • RESTENOSIS • 30% - 50%

• vascular stent is a wire or plastic cylinder that is introduced through a catheter system and positioned across a stenosis to keep the narrowed area spread apart.

• laser energy is directed through a special catheter and pulsed at the atheromatous mass to vaporize it. • This process leaves a smooth, carbonized surface up to 5 mm in diameter,

• a laser-heated probe is advanced through an atheroma to recanalize the vessel lumen.

A cylindrically shaped chamber called the housing with an opening along one side called the housing window. Opposite the housing window is a balloon that, when inflated, presses the atheromatous mass into the window. A round, rotating cutter is then advanced through the housing to cut the atheroma, which is collected in the distal housing chamber. The balloon is then deflated, and the housing window is rotated 90degrees in the vessel.

• Distention of the pelvis and calices of the kidney with urine, caused by ureteral obstruction.

NEPHROSTOMY TUBE • 8 to 12 Fr • 12 inches (30 cm) in length • may be placed for temporary or permanent external drainage of urine. • tubes that are left in place for a long period of time need to be exchanged periodically for new ones. POSITION • prone or • anterior oblique

• Angioplasty of stenoses in the ureteral system, • renal cyst puncture with drainage, • Percutaneous antegrade ureteral stent placement • is an alternative to surgical removal of relatively small kidney stones.

PERCUTANEOUS ANTGRADE URETRAL STENT PLACEMENT 1. A nephrostomy tube is initially placed to provide access to the renal pelvis and to allow a tract to form in the body. 2. At a later time, a guide wire is passed through the nephrostomy tube and down the ureter into the bladder. 3. The nephrostomy tube is removed, and the stent is inserted over the guide wire using a pusher. 4. The nephrostomy tube is replaced to provide external drainage until it is known that the stent is providing internal drainage. 5. The stent can usually be removed through the urethra by a cystoscopic procedure.

may be performed by injecting the drainage catheter to evaluate anatomy and catheter function.

• is an alternative to surgical removal of relatively small kidney stones.

• It is a non-surgical and minimally invasive procedure performed in radiology, usually by an interventional radiologist.

• places chemotherapy and synthetic materials called embolic agents into a blood vessel feeding a cancerous tumor to cut off the tumor's blood supply and trap the chemotherapy within the tumor.

may be used as a standalone treatment or combination with surgery, ablation, chemotherapy or radiation therapy

Types of tace

Chemotherapy drug

Success rate _____ up to ______ years life span

Blood clot

Thrombus becomes dislodged and migrates

Access of IVC filter

Types of IVC filter

IVC also called

Chemoembolization may be used as a standalone treatment or in combination with:

IVC desigbed to be placed in vena cava ranging up to

• Umbrella filter •initially compact inside an introducer catheter device and assume their functional shape as they are released •are designed as a conical shape to trap clots in its central lumen •designed to be placed in vena cava's ranging up to 20 to 30 mm in diameter.

The first true filter designed to trap emboli while maintaining vena cava patency was introduced in 1 967 It consisted of six metal struts joined at one end to form a conical shape that was covered by a perforated plastic canopy

TRUE OR FALSE Procedure • Administration of anesthesia/sedation • Draping • Preparation of puncture site Puncture •Introducer sheath • Introduction of guidewire Inferior vena cavogram • Deployment of IVC filter •Post placement image •Hemostasis