Celiac Axis Arteriography

  1. What does the portal venous system consist of
    the return of blood from the viscera to the liver

    hepatic vein drains into the IVC

    and the IVC transports blood to the right atrium

    the inferior mesenteric vein joins the splenic vein

    the splenic vein & the superior mesenteric vein join to form the portal vein

    and the left gastric vein joins the portal vein
  2. Injection what provides demonstration of the portal system
    the celiac axis or the superior mesenteric
  3. what is the purpose of injecting the celiac axis
    to define pathological conditions and/or localize bleeding
  4. what are indications for the portal system
    • 1. aneurysm
    • 2. tumor
    • 3. stenosis
    • 3. g.i. bleeding
    • 5. cirrhosis of the liver
    • 6. hepatitis
  5. what are some contraindications for the portal system
    • 1. severe ascites: accumulation of fluid in the peritoneal cavity, the result of liver failure, obstructed veins force plasma into the abdominal cavity
    • 2. absence of a spleen
    • 3. blood dyscrasia (a pathological condition of cellular elements of the blood) ex. lukemia
    • 4. low platlet count
    • 5. high clotting time (greater than 15 sec.) ex. pt could bleed out
  6. what is the flush used for in the portal system
    to locate the origin of the celiac artery
  7. what are the recommended catheters used for selective and superselective procedures
    • 1. for selective of celiac, SMA, or IMA you use 2-sided hole caths in order to prevent catheter recoil
    • 2. for superselective like celiac axis arteries you use single hole caths for less superimposition of the other arteries
  8. what type of contrast is used for portal procedures
    non ionic

    and less CM is needed for superselective procedures
  9. whatare the positions used for portal systems
    AP which includes the lower thoracic and the upper abdomen

    if you wand to demonstrate esophageal varices make sure you include the upper abdomen
  10. what type of filming is used for the portal system
    DSA is the choice for many angiographers
  11. what are some iteams that require special care in the portal system filming procedure
    • 1. pt. motion
    • 2. peristalsis
    • 3. uncooperative pt.
    • 4. severly ill pts. who can't hold still
  12. what are some vasodilators that are used in the portal system procedure
    • 1. Papaveine
    • 2. Tolazoline (Priscoline)
  13. what are vasodilators used for in the portal system procedure
    to enhance the venous system
  14. when is a vasodilator given to a pt in the portal procedure
    approximatly 30 secs prior to CM injection
  15. when are the vasodilators contraindicated in a portal procedure
    when there is acute bleeding and AVM
  16. For ct angio a catheter is placed superselectively and smaller slices are done for definitive information
  17. what approach is used for a splenoportography
    • the direct approach
    • 1. needle is placed directly into splenic vein or hepatic vein
    • 2. CM is then injected through the needle

    these are rarely performed today due to the hemorrhages
  18. in order to determine if a pt is bleeding how much must a pt be bleeding in order for it to be demonstrated
    .5 cc's per min
Card Set
Celiac Axis Arteriography
celiac axis arterio.