{"id":2515,"date":"2023-02-09T09:41:06","date_gmt":"2023-02-09T09:41:06","guid":{"rendered":"https:\/\/www.karotidnahirurgija.com\/?page_id=2515"},"modified":"2023-02-24T12:19:43","modified_gmt":"2023-02-24T12:19:43","slug":"6-arteriografija-supraaortalnih-grana","status":"publish","type":"page","link":"https:\/\/www.karotidnahirurgija.com\/?page_id=2515","title":{"rendered":"6. ARTERIOGRAFIJA SUPRAAORTALNIH  GRANA"},"content":{"rendered":"<p><img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/friz-poglavlja2.jpg\" alt=\"\"><br \/>\n<a href=\"\/index.php?page_id=2515\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/6-1.png\" alt=\"\"><\/a><\/p>\n<h1><a href=\"\/index.php?page_id=1408\"><\/p>\n<h1 class=\"western\">ARTERIOGRAFIJA SUPRAAORTALNIH GRANA<\/h1>\n<p><\/a><\/h1>\n<div>\n<p class=\"western\">I do not seek, I find.<\/p>\n<p class=\"western\"><em>Pablo Picasso<\/em><\/p>\n<p class=\"western\">The art of progress is to preserve order amid change and to preserve change amid order.<\/p>\n<p class=\"western\"><em>A.N. Whitehead<\/em><\/p>\n<\/div>\n<div>\n<h4 align=\"JUSTIFY\">Arteriografija je indikovana ako: postoje kontroverze izme\u0111u nalaza ili dileme (globalna simptomatologija, malformacije itd.), dolazi u obzir endovaskularna procedura, ima indikacija za vizualiziranje drugih supraaortalnih grana (brahiocefali\u010dni trunkus, vertebralna i subklavijalna arterija), postoji potreba da se analiziraju intrakranijalne cerebralne arterije.<\/h4>\n<p class=\"western\" align=\"JUSTIFY\"><span style=\"font-size: medium;\"><b>Arteriogra<\/b><\/span><span style=\"font-size: medium;\"><b>fi<\/b><\/span><span style=\"font-size: medium;\"><b>ja<\/b><\/span><span style=\"font-size: medium;\"><b> <\/b><\/span><span style=\"font-size: medium;\">se<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">smatra<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">\u201dzlatnim<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">standardom\u201d<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">u<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">dijagnostici<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">supraaort-<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">alnih<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">grana<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">za<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">planiranje<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">terapijskih<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">alternativa<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">i<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">klju\u010dni<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">faktor<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">indikacionog<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">odlu\u010divanja<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">(<\/span><span style=\"font-size: medium;\"><i>decision<\/i><\/span><span style=\"font-size: medium;\"><i> <\/i><\/span><span style=\"font-size: medium;\"><i>making<\/i><\/span><span style=\"font-size: medium;\"><i> <\/i><\/span><span style=\"font-size: medium;\"><i>process<\/i><\/span><span style=\"font-size: medium;\">).<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">Dobra<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">karotidna<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">arteriogra<\/span><span style=\"font-size: medium;\">fi<\/span><span style=\"font-size: medium;\">ja<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">ne<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">sme<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">biti<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">jednodimenzionalna,<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">da<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">se<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">ne<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">bi<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">previdele<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">lezije<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">(obi\u010dno<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">na<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">zadnjem<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">zidu).<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">Neophodan<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">je<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">arteriografski<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">prikaz:<\/span><\/p>\n<ul>\n<li class=\"western\"><span style=\"font-size: medium;\">intratorakalnog,<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">ekstrakranijalnog<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">i<\/span><\/li>\n<li class=\"western\"><span style=\"font-size: medium;\">intrakranijalnog<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">arterijskog<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">segmenta.<\/span><\/li>\n<\/ul>\n<p class=\"western\" align=\"JUSTIFY\"><span style=\"font-size: medium;\">Arteriogra<\/span><span style=\"font-size: medium;\">fi<\/span><span style=\"font-size: medium;\">ja<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">je<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">\u010desto<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">neizbe\u017ena<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">u<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">slu\u010daju<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">globalne<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">cerebralne<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">ishemije.<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">Arteriogra<\/span><span style=\"font-size: medium;\">fi<\/span><span style=\"font-size: medium;\">ja<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">luka<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">aorte<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">treba<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">da<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">prika\u017ee<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">proksimalne<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">i<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">distalne<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">arterije<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">u<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">odnosu<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">na<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">karotidnu<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">bifurkaciju,<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">jer<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">stanje<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">ovih<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">arterija<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">ne<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">mo\u017ee<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">se<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">uvek<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">pouzdano<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">utvrditi<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">ehografski.<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">U<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">bolesnika<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">sa<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">globalnom<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">simptomatologijom<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">neophodan<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">je<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">prikaz<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">Williso-ovog<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">poligona.<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">Ako<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">je<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">on<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">o\u010duvan<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">karotidna<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">endarterektomija,<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">ako<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">je<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">indikovana,<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">mo\u017ee<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">pru\u017eiti<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">dobar<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">rezultat<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">\u010dak<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">i<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">ako<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">postoje<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">simultane<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">lezije<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">drugih<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">supraaortalnih<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">i<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">intracerebralnih<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">arterija.<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">Hemodinamski<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">zna\u010dajnim<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">se<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">arbitrerno<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">smatraju<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">stenoze<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">preko<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">75%<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">lumena.<\/span><\/p>\n<p class=\"western\" align=\"JUSTIFY\"><span style=\"font-size: medium;\">U<\/span><span style=\"font-size: medium;\"> vreme uvo\u0111enja minimalno invazivnih procedura <\/span><span style=\"font-size: medium;\">u<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">hirurgiju<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">o\u010dekuje <\/span><span style=\"font-size: medium;\">se<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">da<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">bi<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">i<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">dijagnostika<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">morala<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">da<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">bude<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">manje<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">invazivna.<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">Danas<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">od<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">neinvazivnih<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">metoda<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">za<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">detekciju<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">karotidne<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">bolesti<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">koristimo<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">kolor<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">Duplex<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">ultrasonogra<\/span><span style=\"font-size: medium;\">fi<\/span><span style=\"font-size: medium;\">ju,<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">MR<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">angiogra<\/span><span style=\"font-size: medium;\">fi<\/span><span style=\"font-size: medium;\">ju<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">i<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">MSCT<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">angiogra<\/span><span style=\"font-size: medium;\">fi<\/span><span style=\"font-size: medium;\">ju.<\/span><\/p>\n<p class=\"western\" align=\"JUSTIFY\"><span style=\"font-size: medium;\"><b>Multislice<\/b><\/span><span style=\"font-size: medium;\"><b> <\/b><\/span><span style=\"font-size: medium;\"><b>Computed<\/b><\/span><span style=\"font-size: medium;\"><b> <\/b><\/span><span style=\"font-size: medium;\"><b>Tomography<\/b><\/span><span style=\"font-size: medium;\"><b> <\/b><\/span><span style=\"font-size: medium;\"><b>Angiography<\/b><\/span><span style=\"font-size: medium;\"><b> <\/b><\/span><span style=\"font-size: medium;\">(<\/span><span style=\"font-size: medium;\"><b>MSCT<\/b><\/span><span style=\"font-size: medium;\">)<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">ili<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">Multidetector<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">Computed<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">Tomography<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">(MDCT)<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">karotidnih<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">arterija<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">zna\u010dajno<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">skra\u0107uje<\/span><span style=\"font-size: medium;\"> <\/span><span style=\"font-size: medium;\">vreme <\/span>trajanja pregleda, koli\u010dinu zra\u010denja i kontrastnog sredstva, daje manje artefakata i pru\u017ea mogu\u0107nost kvalitetne 3D rekonstrukcije. Danas, posle vi\u0161e generacija MSCT aparata mo\u017eemo re\u0107i ovi nalazi imaju brojne prednosti u poredjenju sa konvencionalnom angiografijom.<\/p>\n<p><multicol id=\"Section14\" dir=\"LTR\" cols=\"2\" gutter=\"3\"><\/multicol><\/p>\n<p class=\"western\" align=\"JUSTIFY\">MSCT angiografija pokazuje stepen stenoze i prirodu plakova, ali i morfologiju karotidnih arterija i odnos sa ostalim strukturama vrata, kao i <i>Willisov<\/i><i> <\/i>poligon. Neophodno je planiranje rekonstruktivnih zahvata trastorakalnim putem. MSCT 3D tehnikom se prikazuju morfolo\u0161ke promene karotidnih arterija u vidu angulacija, elongacija, kinkinga i coilinga. Prisustvo prizidne tromboze se mo\u017ee naslutiti arteriografski, a videti Duplex-sonografski i MSCT-om.<\/p>\n<\/p>\n<p class=\"western\" align=\"JUSTIFY\">Kompletna okluzija se dijagnostikuje sa ve\u0107om specifi\u010dno\u0161\u0107u i senzitivno\u0161\u0107u nego prilikom Duplex-ultrasonografije. Precizna je u odredijivanju prohodnosti distalnog arterijskog segmenta, \u0161to diktira operabilnost lezije. Ulceracija karotidnog plaka se zapa\u017ea kao iregularnost konture zida arterije, sa \u00bbplusom u senci kontrasta\u00ab, ili kao penetrantna ni\u0161a sa kraterom. La\u017eno negativni nalazi se javljaju kada je ulceracija suvi\u0161e mala da bi mogla biti vi\u0111ena. Ulkusni krater mo\u017ee biti ispunjen koagulumom ili prekriven fibroznom kapom.<\/p>\n<p class=\"western\" align=\"JUSTIFY\">Mana MSCT-a je primena jonizuju\u0107eg zra\u010denja i kontrastnog sredstva koje je nefrotoksi\u010dno.<\/p>\n<\/div>\n<p><img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/KNJIGA-Karotidna-hirurgija-63.png\" alt=\"\"><\/p>\n<div>\n<p><em>MSCT angiografija, princip rada<\/em><\/p>\n<\/div>\n<p><img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/CT-pregled-euromedik.jpeg\" alt=\"\"><br \/>\n<img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/KNJIGA-Karotidna-hirurgija-65.png\" alt=\"\"><\/p>\n<div>\n<p style=\"text-align: right;\"><em>Visokostepena stenoza karotidne <\/em><em>bifurkacije (80%) heterogenim plakom sa <\/em><em>ulceracijom prema unutra\u0161njoj karotidnoj <\/em><em>arteriji. MSCT potvrdjuje subokluziju <\/em><em>karotidne bifurkacije i isklju\u010duje <\/em><em>proksimalne i distalne lezije.<\/em><\/p>\n<\/div>\n<p><img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/KNJIGA-Karotidna-hirurgija-66.png\" alt=\"\"><br \/>\n<img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/KNJIGA-Karotidna-hirurgija-67.png\" alt=\"\"><\/p>\n<div>\n<p align=\"CENTER\"><em>Krataka segmentna ateroskleroti\u010dna okluzija unutra\u0161nje karotidne arterije. Prikazuje se spolja\u0161nja karotidna arterija sa svojim granama i plakom na orificijumu<\/em><\/p>\n<\/div>\n<p><img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/KNJIGA-Karotidna-hirurgija-68.png\" alt=\"\"><\/p>\n<div>\n<p align=\"CENTER\"><em>MSCT &#8211; precizna analizua morfologije lezija supraaortalnih arterija<\/em><\/p>\n<p align=\"CENTER\">\n<\/div>\n<p><img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/KNJIGA-Karotidna-hirurgija-69.png\" alt=\"\"><br \/>\n<img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/KNJIGA-Karotidna-hirurgija-70.png\" alt=\"\"><br \/>\n<img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/KNJIGA-Karotidna-hirurgija-71.png\" alt=\"\"><br \/>\n<img decoding=\"async\" src=\"\/wp-content\/uploads\/2023\/02\/KNJIGA-Karotidna-hirurgija-72.png\" alt=\"\"><\/p>\n<div>\n<p><em>Skoro potpuna okluzija brahiocefali\u010dkog trunkusa sa duga\u010dkom totalnom trombozom zajedni\u010dke karotidne arterije levo<\/em><\/p>\n<\/div>\n<div>\n<p><em>MSCT karotidna angiografija pru\u017ea mogu\u0107nost istovremenog sagledavanja karotidnih i drugih arterija koja koje ishranjuju mozak, ali i mo\u017edanog parenhima kao cerebralnog venskog sistema.<\/em><\/p>\n<p align=\"CENTER\"><em>\u00a0<\/em><\/p>\n<\/div>\n<div>\n<p class=\"western\" align=\"JUSTIFY\"><b>ARTERIOGRA<\/b><b>FI<\/b><b>JA<\/b><b> <\/b><b>LUKA<\/b><b> <\/b><b>AORTE<\/b><b> <\/b><b>(arkogra<\/b><b>fi<\/b><b>ja)<\/b><b> <\/b>sa pojavom MSCT angiografije gubi svoje mesto. Selektivna arteriografija treba da prika\u017ee karotidnu bifurkaciju, ali i proksimalne i distalne arterije. Arkografija se izvodi punkcijom femoralne arterije, kateterizacijom i ubrizgavanjem jodnog kontrasta u predelu luka aorte (metod po <i>Seldingeru<\/i>). Selektivna arteriografija karotidne, subklavijalne ili vertebralne arterije indikovana je ako treba precizno vizualizirati distalne lezije na ovim arterijama. Arteriografija treba da se obavi u tri projekcije (neutralna, desna i leva pozicija). Preporu\u010dljiva je panangiografija zbog mogu\u0107nosti istovremenog postojanja intrakranijalnih aneurizmi.<\/p>\n<p class=\"western\" align=\"JUSTIFY\">Arteriografija je suverena u otkrivanju anomalija broja, polo\u017eaja i grananja supra- aortalnih grana. Arteriografija prikazuje dvodimenzionalnu sliku intraluminalnog stuba jodnog kontrasta, pa je logi\u010dno da se pri proceni ulceracija povr\u0161ine karotidnog plaka javljaju poblemi. Prilikom pregleda mogu\u0107a je pojava prolaznog, cirkularnog spazma zbog reakcije na kontrastno sredstvo.<sup><span style=\"font-size: xx-small;\">8-12<\/span><\/sup><\/p>\n<p class=\"western\" align=\"JUSTIFY\">Histolo\u0161ka kompozicija i heterogena struktura plaka ne mogu se dijagnostikovati na osnovu klasi\u010dne arteriografije niti DSA. Ove informacije pru- \u017ea Duplex-sonografija. Lo\u0161e strane arkografije su: slaba pouzdanost u detekciji komplikovanog plaka, slabo prikazivanje intrakranijalnih arterija, upotreba kontrasta, neophodnost kateterizacije. Arteriografija je neprijatna za bolesnika.<\/p>\n<p><em>\u00a0<\/em><\/p>\n<\/div>\n<p><!--more--><br \/>\n<!-- {\"type\":\"layout\",\"children\":[{\"type\":\"section\",\"props\":{\"image\":\"\",\"image_position\":\"center-center\",\"padding\":\"small\",\"preserve_color\":true,\"style\":\"secondary\",\"title_breakpoint\":\"xl\",\"title_position\":\"top-left\",\"title_rotation\":\"left\",\"vertical_align\":\"middle\",\"width\":\"default\"},\"children\":[{\"type\":\"row\",\"children\":[{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\"},\"children\":[{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/friz-poglavlja2.jpg\",\"image_border\":\"rounded\",\"image_box_decoration\":\"shadow\",\"image_svg_color\":\"emphasis\",\"margin\":\"default\"}}]}]}]},{\"type\":\"section\",\"props\":{\"image_position\":\"center-center\",\"padding\":\"xsmall\",\"style\":\"default\",\"title_breakpoint\":\"xl\",\"title_position\":\"top-left\",\"title_rotation\":\"left\",\"vertical_align\":\"middle\",\"width\":\"default\"},\"children\":[{\"type\":\"row\",\"props\":{\"layout\":\"1-4,3-4\"},\"children\":[{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-4\"},\"children\":[{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/6-1.png\",\"image_svg_color\":\"emphasis\",\"link\":\"index.php?page_id=2515\",\"margin\":\"default\"}}]},{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"3-4\"},\"children\":[{\"type\":\"headline\",\"props\":{\"content\":\"\n\n<h1 class=\\\"western\\\">ARTERIOGRAFIJA SUPRAAORTALNIH GRANA<\\\/h1>\",\"link\":\"index.php?page_id=1408\",\"title_color\":\"success\",\"title_decoration\":\"line\",\"title_element\":\"h1\",\"title_font_family\":\"default\"}},{\"type\":\"text\",\"props\":{\"column_breakpoint\":\"m\",\"content\":\"\n\n<p class=\\\"western\\\">I do not seek, I find.<\\\/p>\\n\n\n<p class=\\\"western\\\"><em>Pablo Picasso<\\\/em><\\\/p>\\n\n\n<p class=\\\"western\\\">The art of progress is to preserve order amid change and to preserve change amid order.<\\\/p>\\n\n\n<p class=\\\"western\\\"><em>A.N. Whitehead<\\\/em><\\\/p>\",\"margin\":\"default\"}}]}]}]},{\"type\":\"section\",\"props\":{\"image_position\":\"center-center\",\"padding\":\"xsmall\",\"preserve_color\":true,\"style\":\"secondary\",\"title_breakpoint\":\"xl\",\"title_position\":\"top-left\",\"title_rotation\":\"left\",\"vertical_align\":\"middle\",\"width\":\"default\"},\"children\":[{\"type\":\"row\",\"children\":[{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-4\"},\"children\":[]},{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"3-4\"},\"children\":[{\"type\":\"nav\",\"props\":{\"grid\":\"1\",\"grid_divider\":true,\"image_vertical_align\":true,\"nav_style\":\"primary\",\"show_image\":true,\"show_meta\":true},\"children\":[{\"type\":\"nav_item\",\"props\":{\"icon\":\"git-branch\"},\"source\":{\"query\":{\"name\":\"customMenuItems\",\"arguments\":{\"id\":50,\"parent\":\"\",\"heading\":\"\",\"include_heading\":true,\"ids\":[\"3291\",\"3292\",\"3293\",\"3294\",\"3295\",\"3296\"]}},\"props\":{\"type\":{\"filters\":{\"search\":\"\"},\"name\":\"title\"},\"active\":{\"filters\":{\"search\":\"\"},\"name\":\"active\"},\"content\":{\"filters\":{\"search\":\"\"},\"name\":\"title\"},\"link\":{\"filters\":{\"search\":\"\"},\"name\":\"url\"}}}}],\"name\":\"submeni\"}]}],\"props\":{\"layout\":\"1-4,3-4\"}}]},{\"type\":\"section\",\"props\":{\"image_position\":\"center-center\",\"padding_remove_bottom\":true,\"style\":\"default\",\"title_breakpoint\":\"xl\",\"title_position\":\"top-left\",\"title_rotation\":\"left\",\"vertical_align\":\"middle\",\"width\":\"default\"},\"children\":[{\"type\":\"row\",\"children\":[{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"3-5\"},\"children\":[{\"type\":\"text\",\"props\":{\"column_breakpoint\":\"m\",\"content\":\"\n\n<h4 align=\\\"JUSTIFY\\\">Arteriografija je indikovana ako: postoje kontroverze izme\\u0111u nalaza ili dileme (globalna simptomatologija, malformacije itd.), dolazi u obzir endovaskularna procedura, ima indikacija za vizualiziranje drugih supraaortalnih grana (brahiocefali\\u010dni trunkus, vertebralna i subklavijalna arterija), postoji potreba da se analiziraju intrakranijalne cerebralne arterije.<\\\/h4>\\n\n\n<p class=\\\"western\\\" align=\\\"JUSTIFY\\\"><span style=\\\"font-size: medium;\\\"><b>Arteriogra<\\\/b><\\\/span><span style=\\\"font-size: medium;\\\"><b>fi<\\\/b><\\\/span><span style=\\\"font-size: medium;\\\"><b>ja<\\\/b><\\\/span><span style=\\\"font-size: medium;\\\"><b> <\\\/b><\\\/span><span style=\\\"font-size: medium;\\\">se<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">smatra<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">\\u201dzlatnim<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">standardom\\u201d<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">u<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">dijagnostici<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">supraaort-<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">alnih<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">grana<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">za<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">planiranje<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">terapijskih<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">alternativa<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">i<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">klju\\u010dni<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">faktor<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">indikacionog<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">odlu\\u010divanja<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">(<\\\/span><span style=\\\"font-size: medium;\\\"><i>decision<\\\/i><\\\/span><span style=\\\"font-size: medium;\\\"><i> <\\\/i><\\\/span><span style=\\\"font-size: medium;\\\"><i>making<\\\/i><\\\/span><span style=\\\"font-size: medium;\\\"><i> <\\\/i><\\\/span><span style=\\\"font-size: medium;\\\"><i>process<\\\/i><\\\/span><span style=\\\"font-size: medium;\\\">).<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">Dobra<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">karotidna<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">arteriogra<\\\/span><span style=\\\"font-size: medium;\\\">fi<\\\/span><span style=\\\"font-size: medium;\\\">ja<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">ne<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">sme<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">biti<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">jednodimenzionalna,<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">da<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">se<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">ne<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">bi<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">previdele<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">lezije<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">(obi\\u010dno<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">na<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">zadnjem<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">zidu).<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">Neophodan<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">je<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">arteriografski<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">prikaz:<\\\/span><\\\/p>\\n\n\n<ul>\\n\n\n<li class=\\\"western\\\"><span style=\\\"font-size: medium;\\\">intratorakalnog,<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">ekstrakranijalnog<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">i<\\\/span><\\\/li>\\n\n\n<li class=\\\"western\\\"><span style=\\\"font-size: medium;\\\">intrakranijalnog<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">arterijskog<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">segmenta.<\\\/span><\\\/li>\\n<\\\/ul>\\n\n\n<p class=\\\"western\\\" align=\\\"JUSTIFY\\\"><span style=\\\"font-size: medium;\\\">Arteriogra<\\\/span><span style=\\\"font-size: medium;\\\">fi<\\\/span><span style=\\\"font-size: medium;\\\">ja<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">je<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">\\u010desto<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">neizbe\\u017ena<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">u<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">slu\\u010daju<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">globalne<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">cerebralne<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">ishemije.<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">Arteriogra<\\\/span><span style=\\\"font-size: medium;\\\">fi<\\\/span><span style=\\\"font-size: medium;\\\">ja<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">luka<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">aorte<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">treba<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">da<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">prika\\u017ee<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">proksimalne<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">i<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">distalne<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">arterije<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">u<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">odnosu<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">na<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">karotidnu<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">bifurkaciju,<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">jer<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">stanje<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">ovih<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">arterija<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">ne<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">mo\\u017ee<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">se<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">uvek<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">pouzdano<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">utvrditi<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">ehografski.<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">U<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">bolesnika<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">sa<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">globalnom<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">simptomatologijom<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">neophodan<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">je<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">prikaz<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">Williso-ovog<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">poligona.<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">Ako<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">je<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">on<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">o\\u010duvan<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">karotidna<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">endarterektomija,<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">ako<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">je<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">indikovana,<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">mo\\u017ee<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">pru\\u017eiti<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">dobar<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">rezultat<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">\\u010dak<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">i<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">ako<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">postoje<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">simultane<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">lezije<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">drugih<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">supraaortalnih<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">i<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">intracerebralnih<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">arterija.<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">Hemodinamski<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">zna\\u010dajnim<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">se<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">arbitrerno<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">smatraju<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">stenoze<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">preko<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">75%<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">lumena.<\\\/span><\\\/p>\\n\n\n<p class=\\\"western\\\" align=\\\"JUSTIFY\\\"><span style=\\\"font-size: medium;\\\">U<\\\/span><span style=\\\"font-size: medium;\\\"> vreme uvo\\u0111enja minimalno invazivnih procedura <\\\/span><span style=\\\"font-size: medium;\\\">u<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">hirurgiju<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">o\\u010dekuje <\\\/span><span style=\\\"font-size: medium;\\\">se<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">da<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">bi<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">i<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">dijagnostika<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">morala<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">da<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">bude<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">manje<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">invazivna.<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">Danas<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">od<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">neinvazivnih<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">metoda<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">za<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">detekciju<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">karotidne<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">bolesti<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">koristimo<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">kolor<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">Duplex<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">ultrasonogra<\\\/span><span style=\\\"font-size: medium;\\\">fi<\\\/span><span style=\\\"font-size: medium;\\\">ju,<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">MR<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">angiogra<\\\/span><span style=\\\"font-size: medium;\\\">fi<\\\/span><span style=\\\"font-size: medium;\\\">ju<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">i<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">MSCT<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">angiogra<\\\/span><span style=\\\"font-size: medium;\\\">fi<\\\/span><span style=\\\"font-size: medium;\\\">ju.<\\\/span><\\\/p>\\n\n\n<p class=\\\"western\\\" align=\\\"JUSTIFY\\\"><span style=\\\"font-size: medium;\\\"><b>Multislice<\\\/b><\\\/span><span style=\\\"font-size: medium;\\\"><b> <\\\/b><\\\/span><span style=\\\"font-size: medium;\\\"><b>Computed<\\\/b><\\\/span><span style=\\\"font-size: medium;\\\"><b> <\\\/b><\\\/span><span style=\\\"font-size: medium;\\\"><b>Tomography<\\\/b><\\\/span><span style=\\\"font-size: medium;\\\"><b> <\\\/b><\\\/span><span style=\\\"font-size: medium;\\\"><b>Angiography<\\\/b><\\\/span><span style=\\\"font-size: medium;\\\"><b> <\\\/b><\\\/span><span style=\\\"font-size: medium;\\\">(<\\\/span><span style=\\\"font-size: medium;\\\"><b>MSCT<\\\/b><\\\/span><span style=\\\"font-size: medium;\\\">)<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">ili<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">Multidetector<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">Computed<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">Tomography<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">(MDCT)<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">karotidnih<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">arterija<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">zna\\u010dajno<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">skra\\u0107uje<\\\/span><span style=\\\"font-size: medium;\\\"> <\\\/span><span style=\\\"font-size: medium;\\\">vreme <\\\/span>trajanja pregleda, koli\\u010dinu zra\\u010denja i kontrastnog sredstva, daje manje artefakata i pru\\u017ea mogu\\u0107nost kvalitetne 3D rekonstrukcije. Danas, posle vi\\u0161e generacija MSCT aparata mo\\u017eemo re\\u0107i ovi nalazi imaju brojne prednosti u poredjenju sa konvencionalnom angiografijom.<\\\/p>\\n\n\n<p><multicol id=\\\"Section14\\\" dir=\\\"LTR\\\" cols=\\\"2\\\" gutter=\\\"3\\\"><\\\/multicol><\\\/p>\\n\n\n<p class=\\\"western\\\" align=\\\"JUSTIFY\\\">MSCT angiografija pokazuje stepen stenoze i prirodu plakova, ali i morfologiju karotidnih arterija i odnos sa ostalim strukturama vrata, kao i <i>Willisov<\\\/i><i> <\\\/i>poligon. Neophodno je planiranje rekonstruktivnih zahvata trastorakalnim putem. MSCT 3D tehnikom se prikazuju morfolo\\u0161ke promene karotidnih arterija u vidu angulacija, elongacija, kinkinga i coilinga. Prisustvo prizidne tromboze se mo\\u017ee naslutiti arteriografski, a videti Duplex-sonografski i MSCT-om.<\\\/p>\\n\n\n<p><\\\/p>\\n\n\n<p class=\\\"western\\\" align=\\\"JUSTIFY\\\">Kompletna okluzija se dijagnostikuje sa ve\\u0107om specifi\\u010dno\\u0161\\u0107u i senzitivno\\u0161\\u0107u nego prilikom Duplex-ultrasonografije. Precizna je u odredijivanju prohodnosti distalnog arterijskog segmenta, \\u0161to diktira operabilnost lezije. Ulceracija karotidnog plaka se zapa\\u017ea kao iregularnost konture zida arterije, sa \\u00bbplusom u senci kontrasta\\u00ab, ili kao penetrantna ni\\u0161a sa kraterom. La\\u017eno negativni nalazi se javljaju kada je ulceracija suvi\\u0161e mala da bi mogla biti vi\\u0111ena. Ulkusni krater mo\\u017ee biti ispunjen koagulumom ili prekriven fibroznom kapom.<\\\/p>\\n\n\n<p class=\\\"western\\\" align=\\\"JUSTIFY\\\">Mana MSCT-a je primena jonizuju\\u0107eg zra\\u010denja i kontrastnog sredstva koje je nefrotoksi\\u010dno.<\\\/p>\",\"margin\":\"default\"}}]},{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"2-5\"},\"children\":[{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/KNJIGA-Karotidna-hirurgija-63.png\",\"image_svg_color\":\"emphasis\",\"image_width\":\"500\",\"margin\":\"default\"}},{\"type\":\"text\",\"props\":{\"column_breakpoint\":\"m\",\"content\":\"\n\n<p><em>MSCT angiografija, princip rada<\\\/em><\\\/p>\",\"margin\":\"default\"}},{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/CT-pregled-euromedik.jpeg\",\"image_svg_color\":\"emphasis\",\"image_width\":\"500\",\"margin\":\"default\"}}]}],\"props\":{\"layout\":\"3-5,2-5\"}}]},{\"type\":\"section\",\"props\":{\"image_position\":\"center-center\",\"padding\":\"xsmall\",\"style\":\"default\",\"title_breakpoint\":\"xl\",\"title_position\":\"top-left\",\"title_rotation\":\"left\",\"vertical_align\":\"middle\",\"width\":\"default\"},\"children\":[{\"type\":\"row\",\"props\":{\"layout\":\"1-4,1-4,1-4,1-4|1-2,1-2,1-2,1-2\"},\"children\":[{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-4\",\"width_small\":\"1-2\"},\"children\":[{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/KNJIGA-Karotidna-hirurgija-65.png\",\"image_svg_color\":\"emphasis\",\"image_width\":\"500\",\"margin\":\"default\"}},{\"type\":\"text\",\"props\":{\"column_breakpoint\":\"m\",\"content\":\"\n\n<p style=\\\"text-align: right;\\\"><em>Visokostepena stenoza karotidne <\\\/em><em>bifurkacije (80%) heterogenim plakom sa <\\\/em><em>ulceracijom prema unutra\\u0161njoj karotidnoj <\\\/em><em>arteriji. MSCT potvrdjuje subokluziju <\\\/em><em>karotidne bifurkacije i isklju\\u010duje <\\\/em><em>proksimalne i distalne lezije.<\\\/em><\\\/p>\",\"margin\":\"default\"}}]},{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-4\",\"width_small\":\"1-2\"},\"children\":[{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/KNJIGA-Karotidna-hirurgija-66.png\",\"image_svg_color\":\"emphasis\",\"image_width\":\"500\",\"margin\":\"default\"}}]},{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-4\",\"width_small\":\"1-2\"},\"children\":[{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/KNJIGA-Karotidna-hirurgija-67.png\",\"image_svg_color\":\"emphasis\",\"image_width\":\"500\",\"margin\":\"default\"}},{\"type\":\"text\",\"props\":{\"column_breakpoint\":\"m\",\"content\":\"\n\n<p align=\\\"CENTER\\\"><em>Krataka segmentna ateroskleroti\\u010dna okluzija unutra\\u0161nje karotidne arterije. Prikazuje se spolja\\u0161nja karotidna arterija sa svojim granama i plakom na orificijumu<\\\/em><\\\/p>\",\"margin\":\"default\"}}]},{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-4\",\"width_small\":\"1-2\"},\"children\":[{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/KNJIGA-Karotidna-hirurgija-68.png\",\"image_svg_color\":\"emphasis\",\"image_width\":\"500\",\"margin\":\"default\"}},{\"type\":\"text\",\"props\":{\"column_breakpoint\":\"m\",\"content\":\"\n\n<p align=\\\"CENTER\\\"><em>MSCT - precizna analizua morfologije lezija supraaortalnih arterija<\\\/em><\\\/p>\\n\n\n<p align=\\\"CENTER\\\"><\\\/p>\",\"margin\":\"default\"}}]}]}]},{\"type\":\"section\",\"props\":{\"image_position\":\"center-center\",\"padding\":\"xsmall\",\"style\":\"default\",\"title_breakpoint\":\"xl\",\"title_position\":\"top-left\",\"title_rotation\":\"left\",\"vertical_align\":\"middle\",\"width\":\"default\"},\"children\":[{\"type\":\"row\",\"props\":{\"layout\":\"1-4,1-4,1-4,1-4|1-2,1-2,1-2,1-2\"},\"children\":[{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-4\",\"width_small\":\"1-2\"},\"children\":[{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/KNJIGA-Karotidna-hirurgija-69.png\",\"image_svg_color\":\"emphasis\",\"image_width\":\"500\",\"margin\":\"default\"}}]},{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-4\",\"width_small\":\"1-2\"},\"children\":[{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/KNJIGA-Karotidna-hirurgija-70.png\",\"image_svg_color\":\"emphasis\",\"image_width\":\"500\",\"margin\":\"default\"}}]},{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-4\",\"width_small\":\"1-2\"},\"children\":[{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/KNJIGA-Karotidna-hirurgija-71.png\",\"image_svg_color\":\"emphasis\",\"image_width\":\"500\",\"margin\":\"default\"}}]},{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-4\",\"width_small\":\"1-2\"},\"children\":[{\"type\":\"image\",\"props\":{\"image\":\"wp-content\\\/uploads\\\/2023\\\/02\\\/KNJIGA-Karotidna-hirurgija-72.png\",\"image_svg_color\":\"emphasis\",\"image_width\":\"500\",\"margin\":\"default\"}}]}]}]},{\"type\":\"section\",\"props\":{\"image_position\":\"center-center\",\"padding\":\"none\",\"style\":\"default\",\"title_breakpoint\":\"xl\",\"title_position\":\"top-left\",\"title_rotation\":\"left\",\"vertical_align\":\"middle\",\"width\":\"default\"},\"children\":[{\"type\":\"row\",\"props\":{\"layout\":\"1-2,1-2\"},\"children\":[{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-2\"},\"children\":[{\"type\":\"text\",\"props\":{\"column_breakpoint\":\"m\",\"content\":\"\n\n<p><em>Skoro potpuna okluzija brahiocefali\\u010dkog trunkusa sa duga\\u010dkom totalnom trombozom zajedni\\u010dke karotidne arterije levo<\\\/em><\\\/p>\",\"margin\":\"default\"}}]},{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"1-2\"},\"children\":[{\"type\":\"text\",\"props\":{\"column_breakpoint\":\"m\",\"content\":\"\n\n<p><em>MSCT karotidna angiografija pru\\u017ea mogu\\u0107nost istovremenog sagledavanja karotidnih i drugih arterija koja koje ishranjuju mozak, ali i mo\\u017edanog parenhima kao cerebralnog venskog sistema.<\\\/em><\\\/p>\\n\n\n<p align=\\\"CENTER\\\"><em>\\u00a0<\\\/em><\\\/p>\",\"margin\":\"default\"}}]}]}]},{\"type\":\"section\",\"props\":{\"image_position\":\"center-center\",\"padding\":\"none\",\"style\":\"default\",\"title_breakpoint\":\"xl\",\"title_position\":\"top-left\",\"title_rotation\":\"left\",\"vertical_align\":\"middle\",\"width\":\"default\"},\"children\":[{\"type\":\"row\",\"children\":[{\"type\":\"column\",\"props\":{\"image_position\":\"center-center\",\"media_overlay_gradient\":\"\",\"position_sticky_breakpoint\":\"m\",\"width_medium\":\"\"},\"children\":[{\"type\":\"text\",\"props\":{\"column_breakpoint\":\"m\",\"content\":\"\n\n<p class=\\\"western\\\" align=\\\"JUSTIFY\\\"><b>ARTERIOGRA<\\\/b><b>FI<\\\/b><b>JA<\\\/b><b> <\\\/b><b>LUKA<\\\/b><b> <\\\/b><b>AORTE<\\\/b><b> <\\\/b><b>(arkogra<\\\/b><b>fi<\\\/b><b>ja)<\\\/b><b> <\\\/b>sa pojavom MSCT angiografije gubi svoje mesto. Selektivna arteriografija treba da prika\\u017ee karotidnu bifurkaciju, ali i proksimalne i distalne arterije. Arkografija se izvodi punkcijom femoralne arterije, kateterizacijom i ubrizgavanjem jodnog kontrasta u predelu luka aorte (metod po <i>Seldingeru<\\\/i>). Selektivna arteriografija karotidne, subklavijalne ili vertebralne arterije indikovana je ako treba precizno vizualizirati distalne lezije na ovim arterijama. Arteriografija treba da se obavi u tri projekcije (neutralna, desna i leva pozicija). Preporu\\u010dljiva je panangiografija zbog mogu\\u0107nosti istovremenog postojanja intrakranijalnih aneurizmi.<\\\/p>\\n\n\n<p class=\\\"western\\\" align=\\\"JUSTIFY\\\">Arteriografija je suverena u otkrivanju anomalija broja, polo\\u017eaja i grananja supra- aortalnih grana. Arteriografija prikazuje dvodimenzionalnu sliku intraluminalnog stuba jodnog kontrasta, pa je logi\\u010dno da se pri proceni ulceracija povr\\u0161ine karotidnog plaka javljaju poblemi. Prilikom pregleda mogu\\u0107a je pojava prolaznog, cirkularnog spazma zbog reakcije na kontrastno sredstvo.<sup><span style=\\\"font-size: xx-small;\\\">8-12<\\\/span><\\\/sup><\\\/p>\\n\n\n<p class=\\\"western\\\" align=\\\"JUSTIFY\\\">Histolo\\u0161ka kompozicija i heterogena struktura plaka ne mogu se dijagnostikovati na osnovu klasi\\u010dne arteriografije niti DSA. Ove informacije pru- \\u017ea Duplex-sonografija. Lo\\u0161e strane arkografije su: slaba pouzdanost u detekciji komplikovanog plaka, slabo prikazivanje intrakranijalnih arterija, upotreba kontrasta, neophodnost kateterizacije. Arteriografija je neprijatna za bolesnika.<\\\/p>\\n\n\n<p><em>\\u00a0<\\\/em><\\\/p>\",\"margin\":\"default\"}}]}]}]}],\"version\":\"3.0.25\"} --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>ARTERIOGRAFIJA SUPRAAORTALNIH GRANA I do not seek, I find. Pablo Picasso The art of progress is to preserve order amid change and to preserve change amid order. A.N. Whitehead Arteriografija je indikovana ako: postoje kontroverze izme\u0111u nalaza ili dileme (globalna simptomatologija, malformacije itd.), dolazi u obzir endovaskularna procedura, ima indikacija za vizualiziranje drugih supraaortalnih grana [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-2515","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>6. 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