ABSTRACT
This chapter reviews the vascular anatomy and equipment essential to conducting a proper mesenteric and renal angiographic examination and highlights the proper indications for invasive testing of these vessel territories. The mesenteric arteries arise from the anterior aspect of the lower thoracic and abdominal aorta. These vessels—the celiac trunk, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA)—are responsible for the blood supply to all organs located within the abdominal cavity. The abdominal aortogram is first performed in a standard posteroanterior (PA) projection using digital subtraction. A frame rate of 2-4 frames/sec is typically recommended for renal and mesenteric angiography obtained under digital substraction. The principal indication for mesenteric angiography is evaluation of intestinal ischemia when the computed tomography (CT) scan is not conclusive and the level of clinical suspicion is high. From the brachial artery approach, the mesenteric arteries can usually be easily engaged using a multipurpose diagnostic catheter.
