Translumbar Aortography

Abstract

Clinical experience with 4,613 translumbar aortograms has allowed more exact delineations of the indications for this procedure and the introduction of numerous safety factors in its performance. Safeguards include adequate hydration of the patient, precise needle placement, a limited dose of contrast material, and a single injection. Furthermore, contrast material that not only produces aortograms of excellent diagnostic quality, but that also is well tolerated by the body is required, and 80% sodium iothalamate appears to fulfill these criteria. Indications include aneurysms only under certain circumstances (thoraco-abdominal aneurysms and aneurysms associated with renovascular hypertension), aorto-iliac occlusive disease, renovascular hypertension, abdominal angina, and a number of miscellaneous conditions. Only 2 deaths have occurred among 3,838 consecutive patients, and both of these deaths were caused by acute myocardial infarction. This mortality rate is not dissimilar to that associated with general anesthesia alone in patients of this age group.