Digital subtraction of background and vertebral artery node

The article is professionally consulted by Master, Doctor Le Xuan Thiep - Radiologist - Department of Diagnostic Imaging - Vinmec Ha Long International Hospital.

Digital subtraction angiography and vertebral artery embolization is a procedure performed under a fluorescent screen to induce intravascular occlusion. By this method, some diseases in the vertebral artery are treated such as aneurysms or ruptures due to trauma.

Similar to arteries at other locations in the body, by inserting a catheter at the pathological site of the vertebral artery and injecting a volume of contrast agent, the abnormal images here will be easily identified under the vertebral artery. background capture screen digitizer. At this time, the interventional doctor will inject occlusive materials to cause vertebral artery embolization.
Indications for digitizing scintigraphy and vertebral artery embolization are pathological cases requiring vertebral artery occlusion such as giant or rhomboid cerebral aneurysms; cases of trauma, acute bleeding or invasive vascular diseases due to tumors. Injected materials will cause blockage, blood can no longer flow and limit the risk of primary vascular rupture or stop bleeding progress.
Because of these benefits, especially in potentially life-threatening emergencies, vertebral artery embolization has no absolute contraindications. Relative contraindications to this procedure may be in the presence of coagulopathy, renal failure, a history of obvious allergy to iodinated contrast agents, or pregnancy.

Because it is a sophisticated technique that requires sophistication, patients and relatives need to be thoroughly explained about the procedure to be performed, as well as the associated risks, in order to request cooperation. Next, the patient needs to fast, change into appropriate clothes and arrange to lie on his back on the intervention table, place an intravenous line with 0.9% physiological saline solution. Means of monitoring breathing, pulse, blood pressure, electrocardiogram, SpO2 are mounted on the patient and the indicators are displayed on the screen for easy observation. After cleaning the inguinal and genital areas, the doctor will cover the area with a sterile tissue to prepare for the intervention. In case the patient is overstimulated and poorly cooperated, it is necessary to consider appointing a sedative to facilitate the process.
At the intervention site, the doctor will administer the usual local anesthetic in most cases from the femoral artery, unless this access cannot be done, use other routes such as the axillary artery, brachial artery, primary carotid artery, and radial artery. When the anesthetic takes effect, the doctor will insert a needle and insert the catheter into the artery, leading to the location of the abnormal vertebral artery. Here, the doctor will conduct a pre-examination of the pulse plug by inserting a balloon attached to the microcatheter.
However, before performing the vertebral artery embolization technique, the patient must assess the quality of the circulation by the contralateral control system. This is done by inserting the contralateral femoral artery and inserting the catheter into the contralateral vertebral or carotid artery. In the abnormal lateral artery, the doctor inflates the balloon to completely block the artery while injecting medication through a catheter in the contralateral artery. If parenchymal perfusion on the occlusive side is found to be proportional to that of the healthy side, or it may be slow but not more than 2 seconds, permanent occlusion of the pathological artery is indicated.
In the opposite case, the contralateral artery should be considered for bridging or scaffolding first. Usually, if both vertebral arteries are in good balance, it is still possible to occlude the vertebral artery on one side without testing for embolization.
When performing permanent occlusion of the vertebral artery on one side, the doctor passes the detached balloon through the microwire to the place to be occluded, inflates the balloon, then withdraws the wire and releases the second balloon about 1.5 to 2cm away . The placement of the stopper can be done with a metal spiral material.
Finally, the doctor will determine whether the results are satisfactory or not based on the DSA image of the location of the occlusion in the vertebral artery that needs intervention, to ensure that the occlusion is working well, there is no current. reflux and not displaced to another location. At the same time, the doctor will also check that the pulse before, during and after the blockage is still circulating normally, there are no signs of thrombosis or dissection of the vessel wall. The same holds true for the intracranial collateral circulation.
When the above conditions are ensured, the interventional tools on both sides will be withdrawn. The puncture artery site will be directly pressed by hand for about 15 minutes to stop bleeding and then bandaged for 8 hours. During this time, the patient is limited to bed movement.

As with any intracranial interventional procedure, digital angiography and vertebral artery embolization may carry certain risks, including:
Arterial tear causing intracranial bleeding Dissection Arterial wall Hematoma or bleeding at the puncture site Infection at the puncture site Complications related to anaesthesia, anesthesia, or contrast media In summary, digital angiography and vertebral embolization Life is a topical interventional treatment modality. By passing the endovascular route, brain aneurysms and ruptures at the vertebral artery site can be blocked, minimizing the risk of future complications. At the same time, with minimal invasiveness, fast recovery time, digital background erasure scan and vertebral artery embolization are the preferred method of choice today.
Dr. Le Xuan Thiep has strengths in performing advanced and difficult magnetic resonance and computed tomography techniques such as: coronary computed tomography, cardiac function, cerebral magnetic resonance, perfusion brain and organs,..
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