Improved techniques for lumbar aortography.

The use of a large volume technique (60-100 ml of contrast) for lumbar aortography is recommended for routine use in the investigation of peripheral arterial disease of the legs. With this method lesions are less likely to be missed and more information is obtained. Using the modern contrast media such as iothalamate, the complications due to contrast medium are not significantly greater than with the conventional volume technique. In Leriche syndrome, although the proximal end of the arterial occlusion can be demonstrated using conventional volume anortography, the distal end, and the arteries below the occlusion can usually only be shown by using a relatively large volume of contrast. Movement of a patient with a lumbar aortography needle in position is safe. Additional projections such as obliques to show the origins of the profunda femoris arteries or the arteries of the feet, can be taken if required. Complications due to stripping of the aortic wall are diminished if a blocked ended single side opening lumbar aortography needle is used.