Q. Can you explain Abdominal Aortography?

The abdominal aorta starts at the level of diaphragm (T12). Here too, prior to performing an abdominal aortogram, a sound knowledge of its anatomy is absolutely essential.

Abdominal aortography is performed by femoral approach using a 5F, 6F or 7F pigtail or tennis racquet catheter. If femoral access is not possible, translumbar, axillary, brachial or radial approaches may be helpful. The catheter tip is kept at T12 or L1 level. About 30 to 60 ml of contrast is injected at a rate of 15 to 30ml/sec. At least two views of aorta-AP and lateral are often enough to provide necessary information. Abdominal aortography is useful in assessment of Abdominal Aortic Aneurysms (AAA), Atherosclerotic occlusive disease (ASO), Thrombotic occlusions, Leriche syndrome, Congenital coarctation syndromes, Renal artery involvement, Middle aortic syndrome (Abdominal aortic coarctation), and stenosis/occlusion of the various branches arising from abdominal aorta.

Treatment options for the various disorders include:

1) Percutaneous transluminal Angioplasty

2) Surgical Bypass grafting

3) Endovascular stenting for Abdominal aortic aneurysms