A moving extension to augment the angiographic table in panarteriog- raphy.

Abstract

Diagnostic angiography now ranges literally from “head to toe.” The femoral or axillary approach permits study of the carotid and vertebral arteries, brachiocephalic vessels, aortic arch, aortic branches, and femoral runoff either singly or in any combination. Not uncommonly, a patient will present with symptoms suggesting multivessel disease, e.g., hyper-tension with transient ischemic attacks or claudication of the lower extremities. To expedite diagnosis, the referring physician and angiographer may attempt to study each area of interest in one session. The average range of movement of the angiographic table is approximately 50 inches, which often falls short of the length necessary to move the patient from the rapid changer to the image intensifier in a muItivessel study. Therefore, the patient must be moved bodily along the table and onto the rapid film changer after placement of the catheter, e.g., in selective carotid catheterization following an aortic arch examination. Since the intracranial vessels are of a much smaller caliber than the brachiocephalic branches, the technician strives for the greatest clarity by having the head as close as possible to the surface of the changer unless magnification is used. Such movement of the patient is time-consuming, tedious and strenuous; moreover, it may also dislodge sterile drapes, intravenous tubes, electrocardiographic leads, and even catheters. Probably the greatest number of movements of the patient occur in selective catheterization of the right and left carotid and vertebral arteries following an aortic arch angiogram. The disarray of the patient's sterile field can be quite disconcerting to all involved. Movable plywood or Formica tops have been used, but they leave much to be desired because of the friction of the surfaces on the angiographic table. It is quite a strain for one technician, and additional help is usually necessary in moving the patient. With the help of a local x-ray representative, a a movable extension for the angiographic table has been devised, extending the range of the total table movement and expediting movement of the patient from the rapid changer to the image intensifier (and vice versa) with minimal effort. The range of the table has now been extended to 74 inches. Anodized aluminum stock is clamped onto the side of the angiographic table, and a Formica top from a discarded x-ray table is fitted with a series of ball-bearing rollers to facilitate easy movement of the top within the aluminum edges (Fig. 1). A clamp on the side of the aluminum side rails immobilizes the extension at any point along its course in the longitudinal axis. The superior aspect of the Formica top is cut to the outline of the upper body, permitting the head to be positioned as close as possible to the rapid changer for the lateral series of angiograms (Figs. 2–4).