ABSTRACT
All procedures are performed in a state-of-the-art angiography suite (Multi-Star TOP; Siemens Medical Imaging Systems, Erlangen, Germany) equipped with a 16-inch diameter image intensifier, high resolution 1024 x 1024 pixel digital subtraction imaging matrix with the ability to link with real-time intravascular ultrasound (CVIS/ Boston Scientific Vascular, Inc., Natick, MA). When renal fail ure is present, portions of the diagnostic angiogram are performed using hand injec tion of carbon dioxide as the contrast agent. Intravascular ultrasound (IVUS) using a 7 Fr, 12 MHz catheter is used to define anatomic details such as vessel diameter and qualitatively assess luminal compromise by the dissected flap. Transcatheter hemodynamic pressure measurements in both true and false lumens are obtained to further evaluate the significance of branch vessel involvement before and after interventions.
