Angiography

In January 1896, 1 mo after the announcement of Roentgen's discovery, Haschek and Lindenthal injected a radiopaque mixture into the blood vessels of an amputated hand showing remarkable detail of the vascular anatomy (6). In his 1907 textbook, Roentgen Rays and

Electrotherapeutics, Kassabian describes the vascular anatomy of the thorax, abdomen, kidney, heart, brain, spleen, liver, and stomach in cadavers (7). An X-ray atlas devoted only to the systemic arteries of the body was published in England in 1920 (8,9). In 1923, Berberich and Hirsch reported the first arteriograms and venograms obtained in humans with an injection of 20% strontium bromide. The radiographs of Berberich and Hirsch showed adequate quality of the arteries and veins in the upper extremity and vessel detail was surprisingly good (10). In 1924, Brooks reported the first use of intraarterial sodium iodide as a means of demonstrating the vessels of the lower extremity in humans (11). He reported that his technique was useful for defining the anatomy of the arteries as well as for showing plaque formation and indicating when an amputation of an extremity needed to be performed for compromise of blood supply (11). In 1928, Moniz described the technique of carotid angiography and its application in the study and evaluation of cerebral lesions (12). The use of compliant intravascular catheters occurred in 1929 when Werner Forssmann wanted to develop a method to inject drugs directly into the heart. After practicing a technique on a cadaver, Forssmann used a dissection kit and made an incision in his own antecubital fossa. He then inserted a Dechamps aneurysm needle into his antecubital vein, opened it, and pushed a urethral catheter into his bloodstream. He then had a chest radiograph taken to show that the catheter was within his right atrium. In 1931, Forssmann published a paper describing this event. He is credited with the first heart catheteriza-tion (13).

In 1929, Santos described translumbar aortography and showed that satisfactory visualization of the abdominal aorta and its branches could be accomplished (14). The study of the abdominal aorta depended on the translumbar approach of Santos until 1941, when Farinas described the retrograde passage of a catheter from the femoral artery into the aorta for purposes of aortography (15). It was not until 1953 when the work of Sven Ivar Seldinger revolutionized modern angiography. Seldinger devised a method of percutaneous transfemoral catheterization that is currently in use today. In the May 1953 edition of the Scandinavian medical journal Acta Radiologica, Seldinger reported, "This technique is simpler than it appears on paper and after a little practice should present no difficulties" (16). Seldinger was born in Mora, Sweden in 1921, and was only 32 when he developed his famous technique.

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