Ask Dr. Z

Please help with angiograms done with embolization of AP collaterals. "AP collaterals from right lateral thoracic artery were engaged. This vessel splits into two collaterals, one posterior. This one was engaged, and a second angiogram was performed to delineate the position of the cath in relation to the right axillary artery. Hand injections in right lateral thoracic were performed after deployment an MVP-5Q. No obstruction of the flow of the right axillary artery. Using same catheter to engage left subclavian artery, hand injection was obtained showing at least three large AP collaterals, the largest one arising directly from left axillary artery and directed more anterior. After occlusion of collaterals from left axillary artery, a hand injection was performed demonstrating no obstruction of left axillary artery flow. To delineate the origin of the AP collaterals arising from the abdominal aorta, hand injection using the catheter injecting in the abdominal aorta just below the diaphragm. The collaterals in fact arise from a single large vessel from the celiac trunk and split into two small ones to fill the lower lobes bilaterally."