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Indications For Angiography

–        Femoral arterial puncture is performed if INR <1.8;


–        In case of radial puncture can be accepted an INR <2.2;

–        Femoral arterial access is faster, easier technically but presents several complications;

–        Radial arterial access is more technically difficult, requires a greater experience of an interventionist but has few complications;

–        Making the Allen test before radial approach is desirable;

–        Patients with a glomerular filtration rate below 60 ml / min and with diabetes are at increased risk for the development of contrast nephropathy;

–        Metformin should be stopped in the morning of the procedure and restarted if renal function is stable at 48 hours after the procedure;

–        Diagnostic catheterization has precise indications limited in valvulopathies (where echocardiography remains the method of evaluation);

–        Findings stenosis is affected by cardiac output values; valvular orifice indexed values are taken into account;

–        Valvular regurgitation are appreciated only semi-quantitative;

–        Percutaneous dilation of mitral valve is a technique with proven efficacy;

–        Percutaneous aortic valvuloplasty isolated has limited indications;

–        Transcatheter implantation of the aortic valve is a promising technique for patients with acceptable surgical risk;

–        Pulmonary valvuloplasty balloon is reserved for non-dysplastic cases;

–        Myocardial infarction can be differentiated from acute myocardial infarction by coronary angiography;

–        In dilated cardiomyopathy invasive exploring indicates coronary permeable, absence of other diseases; dilated ventricular, hypokinetic;

–        In obstructive hypertrophic cardiomyopathy is determined intraventricular gradient and coronary anatomy for a possible ablation;

–        Catheterization can differentiate myocardial physiology restriction of the pericardial constriction;

–        Non-invasive imaging (echocardiography, computed tomography, magnetic resonance) can characterize most congenital heart diseases;

–        Catheterization is used selectively for completion of anatomical and functional information and assessment of pulmonary hypertension;

–        Interventional therapy by closing with devices, dilatation, stenting, offering radical solutions / palliative in congenital diseases simple / complex;

Clinical evaluation of noninvasive testing and risk stratification establish the need for a coronary angiography diagnostic in stable angina.biplane2

Stratification indications for coronary arteriography as appropriate, uncertain or inadequate has practical relevance in stable angina.

–        Coronary revascularization is indicated in situations where the expected benefit (survival, clinical improvement) exceeds the risks of the procedure;

–        The success of percutaneous intervention will be defined based on angiographic, procedural and clinical criteria;

–        Invasive attitude in ACS without ST segment elevation (coroarografie with intent to perform revascularization) will be decided on the basis of risk and recurrence of ischemic symptoms;

–        Moment of invasive approach (precocious emergency in the first 72h) will be determined according to the risk, taking into account the clinical status and laboratory results of noninvasive exploration (ECG, ultrasound, biology);

–        Selecting the method of revascularization (interventional or surgical) is based on the same rules as stable angina;

In myocardial infarction with ST elevation – primary angioplasty is the most effective therapy.

–        For the success of angioplasty-existence of a team trained and infrastructure are the key elements, given that the elective percutaneous dilation technique is similar to stable coronaries;

–        If the pharmacological reperfusion method was the first after revascularization, interventional approach will shade depending on the success / failure of fibrinolysis;

–        Diagnostic angiography is considered the exploration of reference in the evaluation of the aortic arch arteries, comparing it with the non-invasive imaging investigations;

–        Percutaneous revascularization is recommended primarily to symptomatic patients;

–        In carotid stenting are commonly used devices for embolism protection;csd-surgery-surgical_disciplines-avm_resection-intraoperative-angiography-00962795~10

–        Revascularization is strictly necessary in patients with critical limb ischemia. It is generally indicated in patients with intermittent claudication with decreased response to drug therapy. Endovascular treatment is not recommended in asymptomatic patients;

–        Indications, technical details depend on the percutaneous therapy (aorto-iliac, femoral-poplitu, infra-popliteal) and the type of lesion;

–        Renal artery stenosis angioplasty, although controversial in the literature, has précised indications guide depending on the patient’s symptoms, severity of injury, renal functional status;

–        Endovascular Therapy of mesenteric revascularization represents the first strategy of intention in symptomatic patients.

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