Catheter Angiography in Pediatric Medicine
Catheter Angiography
Catheter angiography, also known as digital subtraction angiography (DSA), is a minimally invasive imaging technique that provides detailed visualization of blood vessels through direct contrast administration and real-time imaging.
Key Principles
- Gold standard for vascular imaging
- Real-time dynamic imaging
- High spatial and temporal resolution
- Therapeutic intervention capability
Advantages
- Superior vessel visualization
- Dynamic flow assessment
- Immediate intervention possibility
- 3D rotational capabilities
Primary Clinical Indications
- Vascular Malformations
- Arteriovenous malformations (AVMs)
- Arteriovenous fistulas
- Venous malformations
- Capillary malformations
- Cerebrovascular Disorders
- Moyamoya disease
- Vasculitis
- Aneurysms
- Stroke evaluation
- Tumors
- Pre-operative mapping
- Embolization planning
- Vascular supply assessment
- Congenital Heart Disease
- Pulmonary vessel assessment
- Aortic abnormalities
- Collateral vessel mapping
Therapeutic Applications
- Embolization procedures
- Thrombolysis
- Angioplasty
- Stent placement
Technical Components
- Equipment Requirements
- Biplane angiography system
- Digital subtraction capability
- 3D rotational angiography
- Roadmap functionality
- Procedure Steps
- Access site selection (typically femoral)
- Catheter selection and placement
- Contrast administration
- Image acquisition
- Imaging Parameters
- Frame rates: 2-30 fps
- Field of view optimization
- Radiation dose management
Contrast Considerations
- Types of contrast media
- Weight-based dosing
- Injection rates and volumes
- Contrast reactions management
Pediatric-Specific Considerations
- Pre-procedure
- Patient selection
- Risk assessment
- Laboratory evaluation
- Informed consent
- Procedural Considerations
- Anesthesia requirements
- Vascular access challenges
- Catheter sizing
- Radiation protection
- Monitoring Requirements
- Vital signs
- Coagulation status
- Hydration status
- Neurological checks
Complications and Management
- Access Site Complications
- Hematoma
- Pseudoaneurysm
- Arterial injury
- Systemic Complications
- Contrast reactions
- Thromboembolic events
- Radiation exposure
- Prevention Strategies
- Appropriate patient selection
- Technical expertise
- Careful monitoring
- Quick recognition and management
