Procedure of hepatic arteriography needle

1. Patient preparation

(1) Explain the purpose of angiography and the possible complications and accidents to the patients and their families, and sign the angiography agreement;

(2) To explain the process of angiography and matters needing attention to the patient, so as to eliminate concerns and strive for intraoperative cooperation;

(3) To check the heart, liver and renal function, blood routine and clotting time;

(4) Necessary imaging examination, such as B ultrasound, CT, etc.;

(5) Iodine and anesthetics should be treated according to the provisions of pharmacopoeia;

(6) Diet was forbidden 4 hours before operation. Empty urine and feces and train patients to hold their breath;

(7) Skin was routinely prepared at the puncture site, and sedatives were given if necessary;

(8) The establishment of intravenous channels to facilitate intraoperative medication and rescue.

2. Equipment preparation

(1) Cardiovascular X-ray machine and its auxiliary equipment;

(2) Disinfecting kit for angiographic surgical instruments;

(3) Puncture intubation equipment, such as puncture needle, catheter sheath, catheter and guide wire;

(4) Pressure syringes, syringes and connecting tubes.

3. Pharmaceutical preparation

(1) Contrast agent: organic iodine water preparation (40%-76% ionic type or the corresponding concentration of non-ionic type);

(2) anesthetic, anticoagulant and various rescue drugs. 1. Femoral or brachial artery puncture cannulation was performed by Seldinger technique.

2. Selective celiac arteriography followed by superselective hepatic arteriography;

3. Injection parameters included celiac arteriography contrast agent dosage of 30-35ml/time, injection flow rate of 6-7ml /s; The dosage of contrast agent for hepatic arteriography was 20-25 ml/ time, and the injection flow rate was 5-7 ml/s.

4. The angiographic position was anteroposteric and oblique when necessary.

5. The angiography procedure was 3-6 frames /s, and the injection delay was 0.5s. Breath-hold exposure to intrahepatic microvascular stage. When the portal vein was observed by hepatic arteriography, the exposure lasted for 15-20s until the portal vein was displayed.

6. After the angiography, the catheter was removed and local compression was performed for 10-15min.

7. The photography technician shall carefully fill in the inspection application form and sign the relevant items and technical parameters. 1. Complications of puncture and intubation include temporary arterial spasm, local hematoma, pseudoaneurysm and arteriovenous fistula, ductal artery fracture, arterial endarterectomy, atherosclerotic plaque shedding, vascular rupture, cerebrovascular thrombosis and gas embolism, etc.

2. Contrast complications shock, convulsion, epilepsy and cerebral edema, laryngeal edema, laryngeal or (and) bronchospasm, pulmonary edema, acute renal failure, etc.

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