Intravenous Aortography

Abstract

I. Introduction Recent advances in vascular surgery have created an urgent need for accurate and safe diagnostic procedures for the demonstration of lesions of the thoracoabdominal aorta and its main branches. Unfortunately, translumbar aortography has been associated with a considerable number of serious complications and some deaths. 2,5,6,13,15,19 In a recent review article by McAfee and Willson 19 the incidence of serious complications and death in 13,207 abdominal aortograms, including 12,832 translumbar procedures, was 1.02%. The mortality rate alone was 0.28%. For this reason translumbar aortography is now undertaken only in carefully selected patients, and, indeed, Linton 16,17 and others, 13 have abandoned the procedure. Other methods of visualization of the thoracoabdominal aorta have been suggested. These include approaches via the left ventricle, 11 the aortic arch, 19 the carotid, 17 subclavian, brachial, and femoral 22 arteries. However, all of these approaches demand delicate surgical technique and carry the ever-present risk