肺动脉造影操作规程专家共识

Expert consensus on the operating procedures for pulmonary angiography

肺动脉造影是肺血管疾病的重要有创介入诊断方法, 随着肺血管疾病介入诊疗技术的发展, 肺动脉造影临床应用越来越广泛。本共识从肺动脉造影的发展历史、肺动脉的解剖特点、肺动脉造影的适应证和禁忌证、术前准备、手术操作步骤和操作要点、肺动脉造影结果解读以及并发症防治等方面作了详细阐述, 旨在进一步规范肺动脉造影操作, 提升肺血管疾病的临床和介入诊治水平。

Pulmonary angiography is an important invasive diagnostic technique for pulmonary vascular diseases.With the development of pulmonary vascular interventions,pulmonary angiography has been applied more frequently.We focused on the history of pulmonary angiography,anatomy of pulmonary artery,the indications and contraindications of pulmonary angiography,preoperative preparation,operating procedures,the interpretation of pulmonary angiography results and the prevention and management of complications,with the aim of standardizing the operating procedures of pulmonary angiography and improving the diagnosis of pulmonary vascular diseases.Recommendation 1:Given the complexity of pulmonary artery anatomy,pulmonary angiography should be performed in a variety of positions to clearly visualise the morphology of pulmonary artery lesions.Recommendation 2:Pulmonary angiography,as an invasive vascular procedure,should only be performed after the indications have been clearly established,the risks and benefits have been weighed,and informed consent has been obtained.Recommendation 3:Secondary hypertonic or isotonic iodinated contrast agents with iodine concentrations>300 mg/ml are recommended for pulmonary angiography.Recommendation 4:Pulmonary angiography may be performed using the digital subtraction angiography(DSA)mode or cine radiography mode,depending on the patient′s cooperation in breath-holding and the needs of the interventional procedure.Recommendation 5:Pulmonary Flow Grade is recommended to depict the blood flow status of pulmonary artery.Recommendation 6:Following pulmonary angiography,the vital signs,oxygenation status and the condition of the puncture site should be closely monitored.