Interventional and Cath Lab Procedures

what is an angiogram?

diagnostic examination of blood vessels by injecting them with contrast

what is an angioplasty?

treating blood vessels with balloons and stents following or during an angiogram

what is an embolisation?

procedure to deliberately occlude a blood vessel

when would an embolisation take place?

when there is too much blood flow e.g. in tumours

what does EVAR stand for?

endovascular aortic repair

what is an endovascular aortic repair?

treatment of an aortic aneurysm or dissection using stents

what is a fistulogram?

contrast imaging of fistulas

what is a fistula?

the surgical connection of an artery and vein in the arm to provide a suitable targe for dialysis

why are fistulograms needed?

fistulas may narrow and spasm or build up fatty deposits which restricts blood flow

identify the interventional procedure

fistulogram utilising DSA

identify the interventional procedure

percutaneous transhepatic cholangiogram

what is a nephrostomy?

insertion of a drain percutaneously into the kidney to drain urine to prevent hydronephrosis and infection

what is a PICC line insertion?

insertion of a central catheter from the arm, positioned in the vena cava

what is the benefit of radiographic guidance for line insertions?

can see location of lines to ensure correct placement

what is imaged during a nephrostomy?

the kidney and entire length of ureter to look for stones or blockages

what does a health vessel look like in an angiogram?

proximally wide then narrows distally

identify the interventional procedure

endovascular aortic repair

what are pump injector used for?

to inject large amounts of contrast in a controlled precise way

what are common cath lab procedures?

coronary angiogram, coronary angioplasty, cardiac ablation, pacemaker insertions, TAVI

what does TAVI stand for?

trans-catheter aortic valve insertion

what is a coronary angiogram?

examination of coronary arteries by injecting contrast

what is cardiac ablation?

treatment of arrythmia using heat or cold to produce scar tissue to make cardiac tissue insulators

what is a pacemaker?

device which maintains a safe heart rate for a patient with atypical sinus rhythm

what are the different types of pacemakers?

permanent or temporary

how do pacemakers work?

probe in atria senses if electrical activity is occurring then delivers one itself if not detected

where is a pacemaker usually inserted?

in the left shoulder or pectoral region

what are some contraindications of having the pacemaker on the left side?

fistula on the same side or lymph nodes removed due to breast cancer

how are specialist pacemakers like CRT-Ds different to normal pacemakers?

have an implanted cardiac defibrillator attached which can activate if an MI is detected

what kind of patients would have CRT-D pacemakers?

patients with high risk of cardiac arrest due to ventricular fibrillation outside of the hospital

why are TAVIs carried out?

to replace an non-functional aortic valve with a prosthesis

where are the catheters inserted for a TAVI?

through the femoral arteries

what are the procedural steps to a TAVI?

1. aortograms with contrast used to find the valves

2. a wire is fed through the left ventricle to guide the prosthetic

3. a balloon is inflated to open up the prosthetic

4. balloon is deflated and removed, catheters are removed

what cath lab procedure is shown?

trans-catheter aortic valve insertion

why are anticoagulants used in interventional procedures?

reduces formation of thromboses

what are the benefits of interventional radiography?

procedures can be therapeutic as well as diagnostic

what are the disadvantages to interventional radiography?

use of higher exposure factors, more contrast used, some procedures are temporary solutions before a larger surgical intervention,