ANGIOGRAFIJE
The technique was first developed in 1927 by the Portuguese physician and
neurologist Egas Moniz at the University of Lisbon to provide contrasted x-ray
cerebral angiography in order to diagnose several kinds of nervous diseases,
such as tumors, artery disease and arteriovenous malformations.
He is usually recognized as one of the pioneers in this field. Moniz performed
the first cerebral angiogram in Lisbon in 1927, and Reynaldo Cid dos Santos
performed the first aortogram in the same city in 1929. With the introduction of
the Seldinger technique in 1953, the procedure became markedly safer as no
sharp introductory devices needed to remain inside the vascular lumen.
António Caetano de Abreu Freire Egas Moniz
(29 November 1874 – 13 December 1955), known
as Egas Moniz , was a Portuguese neurologist and
the developer of cerebral angiography. He is
sometimes regarded as the founder of modern
psychosurgery,[1] and developing the surgical
procedure termed leucotomy (also known as
lobotomy), for which he became the first
Portuguese national to receive a Nobel Prize in
1949 (shared with Walter Rudolf Hess).[2]
Reynaldo Cid dos Santos performed the
first aortogram in Lisabon city in 1929.
Werner Theodor Otto Forßmann, (August 29,
1904 – June 1, 1979) was a physician from
Germany who shared the 1956 Nobel Prize in
Medicine (with Andre Cournand and Dickinson
Richards) for developing a procedure that
allowed for cardiac catheterization. In 1929,
he put himself under local anesthetic and
inserted a catheter into his own arm. Not
knowing when the catheter might pierce a vein,
he risked his own life and was able to pass the
catheter into his own heart.
Charles T. Dotter, M.D., fathered interventional
radiology on June 10, 1963 at the Czech
Radiological Congress in Karlovy Vary
"The angiographic catheter can be more than a tool
for passive means for diagnostic observation;
used with imagination it can become an
important surgical instrument."
Razvoj angiografije i IR
1. Upotreba mašte – doktori koji nose razvoj
2. Oprema za intrevencije
3. Angiogrfaske sale
Take home
messages
Used with imagination
Seldingerova tehnika
The Seldinger technique is
a medical procedure to obtain
safe access to blood vessels
and other hollow organs. It is
named after Dr. Sven-Ivar
Seldinger (1921-1998), a
Swedish radiologist from Mora,
Dalarna County, who
introduced the procedure in
1953.
IGLA
ŽICA
KATETER
UVODNIK
Siemens ZEEGO
Abdominalna aortografija
Ilijačna angiografija
Ileofemoralna angiografija
Renovazografija
Mezenterična angiografija
Angiografija truncusa coeliacuca
Angiografija truncusa coeliacuca Indirektna lijenoportografija
Torakalna aortografija
Arteriografija subclavie
Arteriografija karotidne arterije
Arteriografija plućne arterije
Intrakranijalna arteriografija
Flebografija noge
Limfografija
Kavografija
Šta se analizira angiografijom
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
50%
75%
75%
95%
Relationship between reduction in diameter
and cross-sectional area
• angiographic view (diameter)
• histologic view (cross-sectional area)
Arnett EN, Isner JM, Redwood DR, et al.
Ann Intern Med 1979;91:350
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Normalan
Fatty
streak
Fibrozni
plak
Aterosklerotski
plak
Ruptura
plaka/
fisura &
tromboza
NAP
}AKS
IM
CVI / TIA
Gangrena
Asimptomatski stadijum
SAP
Intermitentne klaudikacije
Vreme trajanja
KV smrt
Atherosclerosis - Risk factors
•
•
•
•
•
Hypercholesterolemia
Diabetes
Hypertension
Smoking
Relative factors - advanced age, male
gender, hypertriglyceridemia,
hyperhomocysteinemia, sedentary
lifestyle, family history
struktura normalnog arterijskog zida
Funkcije endotela
Permeabilnost
Transport
Metabolička
lipida
aktivnost
Tromboza
Vaskularni
Angiogeneza
Hemostaza
tonus
Imunološki
Zapaljenje
odgovor
Rast tumora ili
metastaza
Critical Diameter
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Lumen (stenoze-okluzije, dilatacije-aneurizme)
Kolaterale
Vaskularizacija (avaskularno hipervaskularizovano)
Angiografija je u savremenoj radiologiji uvod i
kontrola vaskularne intervencije
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Vaskularizacija (avaskularno hipervaskularizovano)