Transcript Renal Angiography

Renal Angiography
Presented by Lisa Erwert
What is Renal Angiography and what
is the prep for an exam?
►a
special x-ray exam to visualize renal blood
circulation
► Inform health care provider of allergies,
pregnancy, or bleeding problems
► Restrict fluids and food
► Some patients are given a sedative
► Remove all jewelry
Kidney Anatomy
Why do we need kidneys?
• Kidneys remove waste from blood
• Measure 11 cm long, 6 cm wide,
and 3 cm thick.
• The kidney is made up of millions of
functioning units called nephrons.
• The nephrons consist of glomerulus and tubules.
• The glomerulus is a network of tiny blood vessels
surrounded by a cup-shaped structure called the
glomerular (Bowman's) capsule.
The concentration of the filtrate is altered by
various processes to form urine
Urine leads into the collecting duct
Then drained into renal pelvis
The ureter connects the renal pelvis and bladder
Lastly, urine is passed out through the urethra
Indications for a renal angiogram
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Renal hypertension
Renal trauma
Renal tumors
Renal neoplasms
Complications after renal transplantation
Evaluate condition of kidneys for potential
donors
Pathologies
Renal Transplant
Contrast
 A nonionic contrast is used
 Quantity injected depends on the size of the
area to be injected
 Renal requires a smaller quantity of contrast of
6-10ml at a rate of 5-6ml/sec.
 Epinephrine injection helps prevent
superimposition of arteries
What equipment is used for renal
angiography?
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Usual catheterization equipment:
– X-ray machines
– Fluoroscope with video monitor
– Catheters
– Flexible guide wire
– Dye
– Pressure-injection device
Renal Positioning and Filming
• Requires a high volume catheter exchanged for
a visceral catheter
• Patient is supine
• CR to kidney of interest
• Filming rate of 2-3 frames/second during the
injection
• Followed by 1 frame/second for 2 seconds
• And 1 fame every other second for 6 seconds
filming con’t…..
 Start
3
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filming 30 seconds after epinephrine
phases should be demonstrated
Nephron - contrast visualized in glomeruli,
tubules, small veins, and capillaries
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Venous - demoed by renal venography
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Arterial – demonstrates lumen size and length
Procedure
► Introduce
contrast
► Give patient anesthetic
► Insert needle
► Place guide wire in artery
► Remove needle
► Place catheter over wire
► Remove wire and inject contrast
► After images are taken, withdraw catheter
► Apply pressure
References
 Renal Angiography. (2005). Retrieved February 20, 2006
from http://renux.dmed.ed.ac.uk.
 Renal Arteriography. (2004). Retrieved February 20, 2006
from http://www.lifespan.org.
 Snopek, A. (1992). Fundamentals of Special
Radiographic Procedures. Philadelphia, PA. WB
Saunders.
 Tortorici, M.R., & Apfel, P.J. (1995). Advanced
Radiographic & Angiographic Procedures: With An Intro
to Specialized Imaging. Philadelphica, PA: F.A. Davis
Company.