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Physics, Techniques and Procedures

Abdominal aortography

imaging of the abdominal aorta including its major branches from the diaphragm to the bifurcation. Often the pelvic arteries are investigated at the same time. The catheter approach is transfemoral or translumbar; alternatively a transaxillary puncture may be chosen. Digital subtraction angiography DSA or conventional rapid serial films are obtained in an AP projection (Fig.1). Additional projections (oblique for the renal artery origin or lateral for the coeliac trunk and superior mesenteric artery origins) are taken as needed.

Ultrasonography including Doppler ultrasound, spiral CT scanning with CT angiography, and MR imaging including magnetic resonance angiography MRA have dramatically reduced the indications for abdominal aortography. Indications are therefore reserved for unclear findings in these noninvasive techniques or for therapeutic purposes. These include mainly aortic dissection for definition of re-entry and/or perfusion of the renal and visceral arteries; traumatic lesions and complications of atherosclerosis such as aneurysms and penetrating ulcers etc., complications after synthetic grafts (leaks etc.). Abdominal aortography is furthermore performed for initial anatomical overview before selective catheterization of the aortic branches.

The pelvic arteries are investigated to the level of the femoral bifurcation (Fig.2) (see iliac arteriography), particularly for aneurysmal and atherosclerotic disease and in trauma.

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Fig.1

Transfemoral abdominal aortogram in AP (a) and left anterior oblique (b) projection in patient with infrarenal abdominal aortic aneurysm.
Abdominal aortography, Fig.1 (a)
Abdominal aortography, Fig.1 (b)
Abdominal aortography, Fig.2 (a)
Abdominal aortography, Fig.2 (b)
Abdominal aortography, Fig.2 (c)