1. History and Pharmaceuticals

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ANGIOGRAPHYIntroduction



Outlines

History.

Pharmaceuticals.

Patient care procedures.

Equipment and image enhancement techniques:

Selection, operation and function of angiographic equipment.

Image enhancement techniques. Procedural angiography:

The heart, pulmonary vascular system and thoracic Aorta.

Visceral angiography.

Peripheral angiography.

Neuroagngiography.

Interventional procedures:

Vascular interventional procedures.

Nonvascular interventional procedures.

Future.



History

1578-1657/ William Harvey: discovered the blood cycle.

1896/ Haschek and Lindenthal: application of contrast media to

angiography.

1924/ Barney Brooks: used iodinated CM on human (femoral

arteriography). 1953/ S. I. Seldinger: percautaneuos needle puncture and catheterization.

1956/ Lindgren: Transfemoral catheter technique.

1959/ Rastelli et al: first therapeutic application.

1965-1970s/ Cordis and Viamonte-Hobbs: electromechanical injector. 1974/ Gruntzig and Hopff: created the double-lumen balloon dilation

catheter.

1976/ S. Wallace: introduction of the term “interventional procedures”.

Mid-1980s: introduction of DSA (digital subtraction angiography).



General radiographer responsibilities

Prepare the angiographic suite prior to the procedure.

Test the equipments.

Load the serial film exchanger.

CM must be prepared for loading within the automatic

injector.

Greet the patient, insure him/her and prepare him/her

for the procedure.



Pharmaceuticals

Routes of administration:

Local: anaesthesia is routinely injected and has immediateeffect.

Systematic: much more complex and has different types:

a) Oral.b) Sublingual.

c) Rectal.

d) Parenteral: injection and there are five approaches:

1. Subcutaneous: tissue beneath skin, usually in the outer thigh or upperarm.

2. Intrathecal (intraspinal): subarachnoid, subdural and lumber.3. Intramuscular: into the deep muscle, usually the gluteus maximus and the

deltoid muscle.

4. Intravenous (IV): for rapid absorption, into the small veins of the hand(basilic or cephalic vein) or deep veins at the elbow (anticubital oraccessory cephalic vein). two ways:

I. Bolus injection.

II. Infusion.



Emergency medications

The crash cart contains different medications which

are manufactured in many ways including:

Small glass vials.

Unmixed (powder concentrate).

Premixed.

Ampules.

Disposable syringe



Emergency medications

Examples of important medications:

1. Epinephrine (Adrenalin): vasoconstrictor increases cardiac output and B.P

treats allergic reaction.

2. Dopamine Hydrochloride (Intropin): construct the visceral BV increases cardiac

output and B.P given for hypotension pt.

3. Isoproterenol Hydrochloride (Isuprel): adrenergic relax smooth muscle lining in

the respiratory system used in the case of cardiogenic shock.

4. Levartenol bitrate (Levophed) maintains B.P and treats hypertension.

5. Procaine Hydrochloride (Lidocaine): local anaesthetic used as cardiac

antiarrhythmic drug.

6. Digitalis: cardiac stimulant strengthen heart beat and increases cardiac output.

7. Hydrocortisone sodium succinate (Solu-Cortef): anti-inflammatory agent

counteract severe allergic reactions.

8. Methylprednisolone (Medrol): same as Solu-Cortef.

9. Diphenhydramine Hydrochloride (Benadryl): common anti-histamine used forminor allergic reactions.

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1. History and Pharmaceuticals