[Translumbar aortography by catheter technique. Methods, indications and value (author's transl)]

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Diagnostic Imaging

Background:

• Translumbar aortography (TLA) is a key diagnostic tool.
• Assessing complication rates and technique variations is crucial for patient safety.

Purpose of the Study:

• To critically analyze the complication rate of TLA using only the catheter technique.
• To compare the safety and efficacy of catheter-based TLA versus rigid cannula injections.
• To evaluate optimal injection directions and aortic puncture sites for TLA.

Main Methods:

• Retrospective analysis of 400 translumbar aortography examinations performed over three years.
• Focus on catheter technique, complication rates, and severity.
• Comparison of downstream and upstream injection techniques.
• Evaluation of low/intermediate aortic puncture sites.

Main Results:

• A total of 13 complications (3.25%) of moderate severity were observed, with no fatal outcomes.
• Complications included hematomas, paravasations, and dissections; only 0.5% were clinically evident.
• Catheter technique demonstrated advantages over rigid cannula injections, reducing dissection risk.
• Downstream injection excelled in visualizing peripheral occlusive vascular disease.
• Upstream injection proved superior for major abdominal arteries and collateral circulation in Leriche syndrome.

Conclusions:

• The catheter technique for translumbar aortography is associated with a low complication rate.
• Rigid cannula injections should be avoided due to a higher risk of complications, particularly dissection.
• Specific injection directions and aortic puncture sites optimize visualization and minimize procedural risks.