A patient propulsion procedure for aorto-arteriography.

Abstract

The development of vascular surgery has required that suitable radiographic procedures be available to illustrate the pathologic or congenital abnormalities present, as well as to give further information relating to altered hemodynamics. The proper planning of a surgical approach is partially dependent on knowledge gained in these areas by radiologic methods. Such procedures are of great use, also, in separating abnormalities not yet amenable to surgical correction. Many methods have been designed for peripheral arteriography and for abdominal aortography since Dos Santos (1) introduced this as a clinical procedure in 1929. Reviews and discussions of the methods have been numerous; briefly, the technics consist of single long-film exposures or serial long-film exposures, multiple combinations of 14 × 17-inch films, or scanography (2–6). In plans for new x-ray departments or revisions of existing areas, consideration is generally given to the purchase of apparatus for cardiac angiography, but infrequently to the acquisition of specific equipment for peripheral arteriography. This situation arose in our own institution. The procedure that we have selected and have developed consists essentially of moving the patient over a serialographic film changer, the rate of movement and the intervals of exposure being known. Earlier efforts in this direction have been made by Christmann (7) and Ellzey (8). The selection was not dictated solely because of possible superiority over other existing methods. The object was to determine whether or not the versatility of previously installed, expensive, specialized equipment (angiocardiographic) could be increased, as well as to reduce the costs that would be necessitated by employing still further “special equipment” such built by Eyler (2) or manufactured for this purpose. The interrelationship of this project with other developments utilizing the same basic equipment is described elsewhere (9). Many radiological departments now have serialographic film changers with a suitable width of coverage to expose both femoral areas simultaneously. These might be used, as will be illustrated, for aorto-arteriography in continuity. The additional expense is small. Equipment The general equipment is illustrated in Figure 1. Its major component is the horizontal plane of a biplane roll film changer; this is placed at the foot of a radiographic table. A Formica-covered plywood platform, measuring 8×2 feet, and 1 inch thick, is suspended over the changer with one end resting on the x-ray table and the other on a simple metal stand. An aperture, the size of the film exposure area, has been cut in this platform in the appropriate place. Two wooden guide-bars run the length of the table; they are separated by 20.5 inches.