Catheterisation for peripheral diagnostic and interventional procedures (old)
Summary
Non-invasive imaging modalities have almost entirely replaced diagnostic peripheral angiography in everyday clinical practice. However, catheter-based angiography remains the procedure of choice in case of inconclusive imaging results or as a foundation for an endovascular revascularisation procedure. A patient’s history of previous endovascular or surgical revascularisation procedures, as well as the clinical presentation and non-invasive imaging results, should be integrated in the planning of an angiographic study with respect to choice of access site, sheath size, and catheters. The specific technicalities of catheterisation for each peripheral territory – lower extremities, visceral arteries, supra-aortic vessels and upper extremities – are described. Complications of peripheral diagnostic angiography are rare and mainly related to access site management, inappropriate manipulation of wires or catheters, and use of nephrotoxic iodinated contrast agents.
Introduction
The purpose of this chapter is to provide an overview of the technical aspects of catheterisation of the peripheral vasculature, including the supra-aortic vessels, the visceral organs (i.e., renal arteries, coeliac trunk and mesenteric arteries), and the upper and lower extremities. General aspects of catheterisation of the peripheral vasculature as well as the vessel anatomy are described in Contrast agents and renal protection (old). Thanks to the good performance of noninvasive imaging modalities such as duplex ultrasound (US), computed tomography angiography (CTA) and magnetic resonance...
Sign up for free!
Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com
- Cholesterol embolization syndrome. Circulation. 2010;122:631-41.
- Endorsed by: the European Stroke Organisation (ESO); Authors/Task Force Members, Tendera M, Aboyans V, Bartelink ML, Baumgartner I, Clément D, Collet JP, Cremonesi A, De Carlo M, Erbel R, Fowkes FG, Heras M, Kownator S, Minar E, Ostergren J, Poldermans D, Riambau V, Roffi M, Röther J, Sievert H, van Sambeek M, Zeller T; ESC Committee for Practice Guidelines (CPG), Bax J, Auricchio A, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Knuuti J, Kolh P, McDonagh T, Moulin C, Poldermans D, Popescu B, Reiner Z, Sechtem U, Sirnes PA, Torbicki A, Vahanian A, Windecker S; Document Reviewers, Kolh P, Torbicki A, Agewall S, Blinc A, Bulvas M, Cosentino F, De Backer T, Gottsäter A, Gulba D, Guzik TJ, Jönsson B, Késmárky G, Kitsiou A, Kuczmik W, Larsen ML, Madaric J, Mas JL, McMurray JJ, Micari A, Mosseri M, Müller C, Naylor R, Norrving B, Oto O, Pasierski T, Plouin PF, Ribichini F, Ricco JB, Ruilope L, Schmid JP, Schwehr U, Sol BG, Sprynger M, Tiefenbacher C, Tsioufis C, Van Damme H. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries * The Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2011;32:2851-906.
- Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM Jr, White CJ, White J, White RA, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American Association for Vascular Surgery; Society for Vascular Surgery; Society for Cardiovascular Angiography and Interventions; Society for Vascular Medicine and Biology; Society of Interventional Radiology; ACC/AHA Task Force on Practice Guidelines Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease; American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; Vascular Disease Foundation. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation. 2006;113:e463-654.
- Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG; TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45:S5-67.
- Schnyder G, Sawhney N, Whisenant B, Tsimikas S, Turi ZG. Common femoral artery anatomy is influenced by demographics and comorbidity: implications for cardiac and peripheral invasive studies. Catheter Cardiovasc Interv. 2001;53:289-95.
- Biondi-Zoccai GG, Agostoni P, Sangiorgi G, Dalla Paola L, Armano F, Nicolini S, Alek J, Fusaro M. Mastering the antegrade femoral artery access in patients with symptomatic lower limb ischemia: learning curve, complications, and technical tips and tricks. Catheter Cardiovasc Interv. 2006;68:835-42.
- Hildick-Smith DJ, Khan ZI, Shapiro LM, Petch MC. Occasional-operator percutaneous brachial coronary angiography: first, do no arm. Catheter Cardiovasc Interv. 2002;57:161-5.
- Verschuyl EJ, Kaatee R, Beek FJ, Patel NH, Fontaine AB, Daly CP, Coldwell DM, Bush WH, Mali WP. Renal artery origins: best angiographic projection angles. Radiology. 1997;205:115-20.
- Beregi JP, Mauroy B, Willoteaux S, Mounier-Vehier C, Rémy-Jardin M, Francke J. Anatomic variation in the origin of the main renal arteries: spiral CTA evaluation. Eur Radiol. 1999;9:1330-4.
- Qureshi AI, Alexandrov AV, Tegeler CH, Hobson RW 2nd, Dennis Baker J, Hopkins LN; American Society of Neuroimaging; Society of Vascular and Interventional Neurology. Guidelines for screening of extracranial carotid artery disease: a statement for healthcare professionals from the multidisciplinary practice guidelines committee of the American Society of Neuroimaging; cosponsored by the Society of Vascular and Interventional Neurology. J Neuroimaging. 2007;17:19-47.
- Patel AD, Gallagher AG, Nicholson WJ, Cates CU. Learning curves and reliability measures for virtual reality simulation in the performance assessment of carotid angiography. J Am Coll Cardiol. 2006;47:1796-802.
- Connors JJ 3rd, Sacks D, Furlan AJ, Selman WR, Russell EJ, Stieg PE, Hadley MN; NeuroVascular Coalition Writing Group; American Academy of Neurology; American Association of Neurological Surgeons; American Society of Interventional and Therapeutic Radiology; American Society of Neuroradiology; Congress of Neurological Surgeons; AANS/CNS Cerebrovascular Section; Society of Interventional Radiology. Training, competency, and credentialing standards for diagnostic cervicocerebral angiography, carotid stenting, and cerebrovascular intervention: a joint statement from the American Academy of Neurology, American Association of Neurological Surgeons, American Society of Interventional and Therapeutic Radiology, American Society of Neuroradiology, Congress of Neurological Surgeons, AANS/CNS Cerebrovascular Section, and Society of Interventional Radiology. Radiology. 2005;234:26-34.
- Fayed AM, White CJ, Ramee SR, Jenkins JS, Collins TJ. Carotid and cerebral angiography performed by cardiologists: cerebrovascular complications. Catheter Cardiovasc Interv. 2002;55:277-80.