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Abstract:
The value of pancreatic pharmacoangiography was assessed in 269 visceral angiograms comparing pre- and postpharmacoangiographic series. Angiotensin as a vasoconstrictor was studied in 179 patients, Adrenalin in 50 patients. Experiences with vasodilators based on 40 angiograms carried out with Secretin and Tolazolin were evaluated respectively. After application of Angiotensin, enhanced filling of small arteries in the head of the pancreas was achieved in 75% of patients. Good filling of small arteries of the body of the pancreas rose from 26 to 55%, while angiography with vasoconstrictors seems of low value in the tail of this organ (20% improvement). The diagnostic information of angiography was improved in 4 of 43 carcinomas (10%). Confirmation or exclusion of questionable pathologic alterations are a further, though not measurable advantage of this method. Pharmacoangiography with constrictors is recommended as an alternative method if superselective angiography is not possible. The use of vasodilators for better imaging of the pancreatic parenchyma is of no significant diagnostic value. The use of vasodilators for better presentation of the spleno- and mesenterico-portal axis is advisable because dilatation of the capillary system permits application of larger doses of contrast medium and a higher flowrate. This causes early and more intensive imaging of the veins.