How is pulmonary angiography performed? Pulmonary angiography steps

In daily life, many patients suffer from dizziness and difficulty breathing, and they are suspected of suffering from pulmonary artery disease. The diagnosis can be confirmed by angiography through puncturing the femoral vein under local anesthesia, introducing a pigtail catheter, and placing the tip of the catheter into the main trunk of the pulmonary artery through the right atrium and ventricle.

1. Indications

Pulmonary angiography is used for:

1. Severe hemoptysis caused by pulmonary artery disease.

2. Pulmonary artery aneurysm.

3. Congenital pulmonary arteriovenous malformations.

4. Pulmonary arteriovenous fistula.

5. Pulmonary embolism.

2. Preparation

1. Patient Preparation

(1) Explain the purpose of angiography and possible complications and accidents to the patient and his family, and sign an angiography agreement.

(2) Inquiry into medical history and necessary imaging examinations, such as chest X-ray, CT, fiberoptic bronchoscopy, etc.

(3) Check heart, liver, and kidney function, as well as blood routine and blood clotting time.

(4) Iodine and anesthetic agents should be handled as required by the pharmacopoeia.

(5) Do not eat or drink for 4 hours before surgery. Administer 10 mg of diazepam (Valium) intramuscularly 0.5 hours before surgery.

(6) Routine skin preparation at the puncture site.

(7) Measure arterial oxygen partial pressure or blood oxygen saturation when necessary.

(8) Establish intravenous access to facilitate intraoperative medication and rescue.

2. Equipment Preparation

(1) Cardiovascular X-ray machine and its accessories.

(2) Sterilization kit for angiographic surgery instruments.

(3) Puncture and intubation equipment, such as puncture needles, catheter sheaths, pigtail catheters and guide wires.

(4) Pressure syringe and its syringe barrel and connecting tube.

(5) Bronchoscope, endotracheal intubation equipment, suction device and artificial respirator, etc.

(6) ECG monitors, cardiac defibrillators and other cardiopulmonary resuscitation equipment.

3. Drug preparation

(1) Contrast agent: organic iodine aqueous preparation (40% to 76% ionic form or non-ionic form of corresponding concentration).

(2) Anesthetics, anticoagulants and various rescue drugs.

III. Methods

1. Under local anesthesia, puncture the femoral vein, introduce the pigtail catheter, and place the tip of the catheter into the main pulmonary artery through the right atrium and ventricle.

2. Injection parameters: contrast agent dosage 20-40 ml/time, injection flow rate 13-16 ml/s.

3. The imaging positions are anteroposterior and lateral, and oblique position can be added when necessary.

4. The imaging program is 15-50 frames/s, and the injection delay is 0.5s. Each angiography should include arterial phase, microvascular phase, and venous phase images.

5. After angiography, remove the catheter, apply local pressure for 10 to 15 minutes, and then apply pressure bandage.

6. The photography technician shall carefully fill in the relevant items and technical parameters of the inspection application form and sign it.