Position of Skin Puncture in Translumbar Aortography

Abstract

In patients with severe distal aortic or bilateral iliac disease, aortography using Seldinger technique via the femoral route is sometimes difficult or impossible, and often hazardous because of the risk of intimal dissection. Brachial or axillary approaches are alternatives, but they are not without difficulties or complications (2, 3). Translumbar aortography (TLA) appears to have fallen out of favour, - although a survey in 1984 (6) showed some 32% of radiologists did use it routinely for aorto-iliac disease. In our department, TLA is regularly performed, and is favoured by the radiologists and the vascular surgeons. We believe TLA is a safe procedure in the hands of those who attain a high level of expertise by regular practice. It should remain within the angiographer's armamentarium where transfemoral or transaxillary/brachial catheterization is impracticable (4).The most unnerving aspect of TLA for the novice is the arterial puncture itself, as this is a “blind” procedure. the description of the te...