Cardiac catheterization and angiography

Cardiac catheterization/angiography is indicated for evaluation of patients with coronary, valvular, and congenital heart disease in whom diagnostic or therapeutic decisions cannot be made on the basis of non-invasive tests. Most patients presenting for cardiac catheterization have coronary artery disease: catheterization and coronary angiography are integral parts of interventional treatments for patients experiencing ischaemic coronary syndromes. Vascular access is usually obtained percutaneously from the femoral, radial, or brachial artery (for the left heart), or the femoral, internal jugular, or brachial/antecubital vein (for the right heart). Cardiac catheterization/angiography permits interventions, particularly coronary angioplasty/stenting, that are of great and increasing therapeutic importance. This chapter reviews the diagnostic applications of cardiac catheterization and angiography.

VARIATIONS IN BRANCHING PATTERN OF BRACHIAL ARTERY - A STUDY IN CADAVERS

Brachial artery in arm is commonly used for percutaneous arterial catheterization, angiography, vascular flaps for reconstructive surgeries, and can be injured in fractures of arm or elbow region. Knowledge of variations in branching pattern is must for all clinicians and especially for vascular and orthopaedic surgeons to avoid complications like haemorrhage, ischemia and necrosis during various surgical procedures. This study was done to observe variations in branching pattern of brachial artery in cadavers and its clinical applications. The study was conducted on eighty upper limbs of 40 cadavers (30 males and 10 females) of age group 50-70 years in the Dept of Anatomy, R.N.T. Medical College, Udaipur (Raj). In 30 cadavers branching pattern of brachial artery was normal. In 10 cadavers either unilaterally or bilaterally variable branching pattern was noticed in the form of (1) Absence of profunda brachial artery (2) Origin of Profunda brachii artery from axillary artery (3) Termination of brachial artery i.e. in the middle of arm into radial and ulnar artery (4) Termination of brachial artery in arm into medial and lateral branches continuing distally as radial and ulnar artery respectively. Genetic predisposition, chemical factors or hemodynamic forces can be the reasons for arterial variations in the upper limb.

Radial versus femoral access in cardiac catheterization and angioplasty. a comparative study

Introduction: The radial artery’s use for performing cardiac catheterization, angiography and angioplasty of the coronary vessels, is an alternative way versus the access widely utilized femoral artery.Aim: The aim of this study was to assess the potential advantages of radial versus femoral access.Material and Method: The study population was 202 patients, who were referred to coronary angiography or intervention coronary angioplasty.Statistical analysis was performed using the statistical package SPSS ver.18. For evaluation of pain was used Visual Numeric Pain Intensity Scale (visual analogue scale, VAS), which comprises using a calibrated scale of 0- 10.Results: From 1 to 30 May 2014 underwent coronary angiography in 202 patients, of whom 112 (55.4%) with RA and 90 (44.6%) with FA.Patients in the RA group showed higher VAS scores (1 ± 0.1) than those in FA group after catheterization (0.2 ± 0.4) P <0.001 + . In contrast, patients in the FA group had higher percentage of injuries / extravasations (13.3%) compared with the RA group (0.9%) P <0.001. Τhe time fluoroscopic was significantly higher in the FA (12.6 ± 10.5) compared to RA (7.6 ± 8.3) P <0.001. About the time of hospitalization, those who underwent femoral access were hospitalized significantly longer (2.6 ± 1.3) compared to patients who underwent radial access (2 ± 1.3) P <0.001+ .Conclusions: The efficacy and safety of the method in combination with the smallest rate of local complications are able to establish access way first choice in hemodynamically laboratories.

Cardiac catheterization and angiography

Cardiac catheterization/angiography is indicated for evaluation of patients with coronary, valvular, and congenital heart disease in whom diagnostic or therapeutic decisions cannot be made on the basis of noninvasive tests. Most patients presenting for cardiac catheterization have coronary artery disease: catheterization and coronary angiography are integral parts of interventional treatments for patients experiencing ischaemic coronary syndromes....