Hva er Angiografi

Sett der e sa mm en 2 og 2, diskutèr h va an giogr a fi er .

Skr iv n ed stikkor d.

Velg u t 3 stikkor d/ b eskr ivelser som kar akter iser er a ngiogr afi.

Tid ca . 5 m in .

Høgskolen i Oslo

Hva er Angiografi - en hist orisk oversikt

Høgskolen i Oslo

   3000 B.C. — Egyptians perform bladder catheterizations using metal pipes.

400 B.C. — Catheters fashioned from hollow reeds and pipes are used in cadavers to study the function of cardiac valves.

1711 — Hales conducts the first cardiac catheterization of a horse using brass pipes, a glass tube and the trachea of a goose.

 1844 — French physiologist Bernard coins the term "cardiac catheterization" and uses catheters to record intracardiac pressures in animals.

 1929 — First documented human cardiac catheterization is performed by Dr. Werner Forssmann in Eberswald, Germany.

  1941 — Cournand and Richards employ the cardiac catheter as a diagnostic tool for the first time, utilizing catheter techniques to measure cardiac output.

1956 Cournand states in his acceptance speech "the cardiac catheter was...the

key in the lock."

1958 — Forssmann, Cournand and Richards share the Nobel Prize.

— The diagnostic coronary angiogram — the key to selective imaging of the heart is discovered by Dr. Mason Sones Høgskolen i Oslo

 1964 — Transluminal Angioplasty, the concept of remodeling the artery, is introduced by Dr. Charles T. Dotter   1967 — Dr. Rene Favaloro conducts first saphenous vein graft (bypass) surgery in Cleveland 1967 — Introduction of the Judkins Technique of coronary angiography  1974 — Andreas Gruentzig performs first peripheral human balloon angioplasty  1976 — Gruentzig presents results of animal studies of coronary angioplasty at American Heart Association meeting  1977 — First human coronary balloon angioplasty performed intraoperatively by Gruentzig , Myler and Hanna in San Francisco  1977 — Andreas Gruentzig worldwide registry performs first cath lab PTCA on awake patient in Zurich; starting with this case, all PTCA data is entered into a Høgskolen i Oslo

 1978 — First PTCA cases performed in America by Myler in San Francisco and Stertzer in New York; Gruentzig conducts first demonstration course in Zurich, Switzerland, attended by 28 pioneering physicians; International Dilatation Society is established     1980 — Gruentzig conducts the last of five demonstration courses in Zurich with Sones, Judkins and Dotter in attendance; he then moves to Atlanta, GA where be becomes Director of Interventional Cardiology at Emory University; National Heart, Lung & Blood Institute begins support of the existing PTCA registry; first 1000 angioplasties are performed worldwide; guiding catheters are introduced 1982 — over-the-wire coaxial balloon systems introduced, brachial guiding catheters & steerable guide wires are developed 1985 other — A year of loss in the history of interventional medicine: Dotter, Sones, Judkins and Gruentzig all pass away within nine months of each 1986 — coronary atherectomy devices are introduced Høgskolen i Oslo

    1987 — first use of coronary stents in humans is reported 1987-1993 stents — a large number of new interventional devices are invented and perfected; some, like lasers, are less effective than hoped for; others are approved and used worldwide; these devices include rotational atherectomy devices (Rotablator), intravascular ultrasound (IVUS) and 1993-1997 — stents become commonplace and eliminate many complications 1997 — over one million angioplasties will be performed worldwide, making angioplasty the most common medical intervention in the world References — For further information on the history of PTCA, we recommend the following articles: Mueller R. and Sanborn T.

The History of Interventional Cardiology, Am Heart J 1995;129:146-72 Myler R., Stertzer, S.

Coronary and Peripheral Angioplasty: Historic Perspective, Textbook of Interventional Cardiology (2nd Ed.) Vol. 1. Topol, E. (Ed.) WB Saunders Co., Philadelphia,1993 King, S.B.

Angioplasty From Bench to Bedside to Bench, Circulation 1996;93:1621-1629 Høgskolen i Oslo

• PTA • PTCA • ERCP • MUCG

Forkortelser

• HSG • PTC • PCI • DSA Høgskolen i Oslo

Forkortelser • PTA -

Percutan Transluminar Angioplastikk

• PTCA -

Percutan Transluminar Coronar Angioplastikk

• ERCP -

Endoskopisk Retrograd CholeangioPancreaticografi

• MUCG -

Miksjons UrethroCystoGrafi

• HSG -

HysteroSalpingoGrafi

• PTC -

Percutan Transhepatisk Choleangiografi

• PCI -

Percutan Coronar Intervensjon (http://home.online.no/~hvikmo/koronar3.html)

• DSA -

Digital Subtraksjons Angiografi Høgskolen i Oslo

Dr. Judkins in action

Høgskolen i Oslo

Pasienttyper - diagnostikk

Høgskolen i Oslo

• Hypertensjon • Atherosclerose – Arteriosclerosis obliterans – Gangren – Aneurysme • Arteritt • Apoplexia cerebri • Trombose • Emboli • Lungeemboli • Angina pectoris • Hjerteinfarkt • Mitralinsuffisiens • Aortainsuffisiens • Flere forslag ???

Høgskolen i Oslo

Katetertyper

Høgskolen i Oslo

Katetertyper / utstyr

•

CSI

•

Guid ewir es

•

Dia gn ostic ca theter s

•

Guid ing cath eter s

•

Balloon ca theter s

•

Stents

•

Misc.

Høgskolen i Oslo

Høgskolen i Oslo

Høgskolen i Oslo

Innstikksted

• Aa. Femor a lis • Aa. Radialis • Tr an slum ba l • Aa. Br ach ia lis Høgskolen i Oslo

Pasientomsorg

• In for m as jon før un der søkelse n • Forb er edelse av pa sien t • Sa m ta le m ed pa sien ten un der un der søkelse n • Hvor da n for h olde seg t il pa sien ten un der un der søkelse n • Tr ygg pa sie nt Høgskolen i Oslo

St rålehygiene?

Høgskolen i Oslo

Bildeeksempler

Høgskolen i Oslo

Aa.femoralis

A.femoralis

Aa.poplietea

A.poplietea

Stenose i en Coronararterie