The Abdominal Aorta and Its Branches

Abstract

The abdominal aorta and its branches are responsible for transporting blood into the arteries of the pelvis and lover extremities and maintaining the parenchymal function of the liver, spleen, pancreas, adrenals, and kidneys. Angiography visualizes in a highly specific way not only primary vascular lesions of different anatomical areas of the abdomen but also parenchymal lesions of different etiology. Thus, conventional x-ray angiography was considered the method of choice for many years before newer noninvasive technologies became available such as ultrasonography (US) and computed tomography (CT). These methods were introduced successfully into the diagnotic armamentarium for evaluating parenchymal and perivascular disorders as well as vascular abnormalities, particularly in vessels with larger diameters. Contrast-enhanced CT and color Doppler US have in fact revolutionized the diagnostic approach in abdominal vessel disease. Due to the high accuracy of US and CT in these areas, indications for angiography have been reduced and changed significantly. Today, abdominal angiography still plays a prominent role as a highly accurate diagnostic procedure in vasoocclusive disease, renovascular disease, and gastrointestinal bleeding that cannot be localized by endoscopy, particularly in cases in which therapeutic interventions can be performed during the same procedure by the radiologist (i. e., recanalization by administration of fibrinolytic agents or transluminal angioplasty or implantation of vascular stents, embolization therapy using different agents and materials, and localized administration of chemotherapeutics). Furthermore, angiography has proved useful for preoperative vascular mapping in order to demonstrate abnormal vascular supply or intraparenchymal vasculature prior to local tumor resection.