What are the must-know aspects to preparing for and performing the most frequently requested diagnostic and therapeutic interventional procedures? Interventional Radiology: A Survival Guide, 4th Edition gives you the information you need to provide safe care in an easy-to-read, concise format. Written by experienced radiologists Drs. H. David Kessel and Iain Robertson, this edition features clear, step-by-step instructions for fundamental skills in this fast-growing field.
Extensively restructured into 4 sections:
Core interventional skills; Essential equipment; Principles of Vascular intervention and Principles of Non-vascular intervention.
Increased emphasis on Interventional Oncology including the management of cancer and its complications.
Expert Consult™ eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.
Nearly 300 line diagrams and photos illustrate procedures, including anatomical and technical points.
Tip boxes highlight key facts and technical recommendations.
Troubleshooting guides help get you back on track when things don’t go exactly as planned.
Warning boxes highlight common and important pitfalls.
Author(s): David Kessel, Iain Robertson
Edition: 4th
Publisher: Elsevier
Year: 2017
Language: English
Commentary: TRUE PDF
Pages: 386
Tags: Radiology
Interventional Radiology: A Survival Guide......Page 2
Copyright Page......Page 4
Preface......Page 5
Abbreviations......Page 6
Preparing for successful and safe procedures......Page 7
Information......Page 8
Consent issues......Page 9
Children......Page 10
The patient has a history of anaphylactic reaction to intravascular contrast......Page 11
Renal impairment......Page 12
Hypertension......Page 13
Patients with dementia, anxiety and agitation......Page 14
Advance review checklist......Page 15
Individual patient safety checks......Page 16
Post-procedure check and aftercare......Page 18
Basic principles for using intravascular contrast......Page 20
Idiosyncratic reactions......Page 21
Reducing the risk......Page 22
Severe hypotension......Page 23
Negative contrast agents – carbon dioxide (CO2)......Page 24
Injecting CO2......Page 25
There is gas trapping......Page 26
The distal vessels cannot be seen......Page 27
To sedate or not to sedate, that is the question......Page 28
Care......Page 29
Aftercare......Page 30
If a procedure is likely to have painful consequences......Page 31
During a procedure......Page 32
Drugs on discharge......Page 33
Specific to a procedure......Page 34
Seeking assistance......Page 35
Learning from complications......Page 36
Confirm symptomatology......Page 37
Alternative therapeutic strategies......Page 38
Clinics running behind schedule......Page 39
Discharge from the clinic......Page 40
Measurements......Page 41
Location, location, location......Page 42
Gauge:......Page 43
Description......Page 44
Know how to use it......Page 45
Fully automatic:......Page 46
Coaxial access set (neff/accustick)......Page 47
Know how to use it......Page 48
Wire tip......Page 49
Hydrophilic guidewires......Page 50
Support non-steerable guidewires – in increasing stiffness......Page 51
Know how to use it......Page 52
Coating......Page 54
Flow rates for non-selective catheters......Page 55
Cobra......Page 56
Headhunter......Page 57
Measurements......Page 58
Know how to use it......Page 59
Measurements......Page 60
Know how to use it......Page 61
Description......Page 62
Sheath flushing:......Page 63
There is a blood clot in the sheath:......Page 64
Description......Page 65
Splitting the sheath:......Page 66
What you intend to pass through it......Page 67
Know how to use it......Page 68
Three-way taps......Page 69
Fitting......Page 70
Tuohy–Borst adaptors......Page 71
High-pressure connectors......Page 72
Pin-vice......Page 73
Know how to use it......Page 74
Delivery catheter......Page 76
Multi-loop snares......Page 77
Know how to use it......Page 78
Monorail – rapid exchange......Page 79
Balloon rated inflation pressure (atmospheres)......Page 80
Know what to ask for......Page 81
Before removing the balloon......Page 82
Removing the balloon through the sheath......Page 83
Know what to ask for......Page 84
Deflation......Page 85
Nitinol......Page 86
Catheter length (cm)......Page 87
Trackability......Page 88
Will imaging be required in the future?......Page 89
Contemporary pusher and sheath systems......Page 90
A note on the Wallstent......Page 91
Bifurcated......Page 93
Spontaneous and iatrogenic arterial rupture......Page 94
Planned elective repair of aneurysmal disease......Page 95
Diameter (French size)......Page 96
Know how to use it......Page 97
Diameter of the coil wire......Page 98
Introducing coils into the catheter......Page 99
Know what to ask for......Page 100
Know what to ask for......Page 101
Know how to use it......Page 102
Know what to ask for......Page 103
Know how to use it......Page 104
Gelfoam pledgets......Page 105
Autologous blood clot......Page 106
Know how to use it......Page 107
Know what to ask for......Page 108
Deployment......Page 109
Directing punctures......Page 110
Patient positioning......Page 112
Fluoroscopic guidance......Page 113
Collimation/image area......Page 115
Radiation protection is so important here is a guide to good fluoroscopy......Page 116
Arterial puncture......Page 118
Passage of the guidewire......Page 119
The wire will not advance beyond the needle tip......Page 120
The wire stops after a short distance......Page 121
Introduction of a dilator, sheath or catheter......Page 122
Common femoral artery......Page 123
Antegrade puncture......Page 124
Superficial femoral artery......Page 125
Esoteric arterial access sites......Page 126
Venous puncture......Page 127
Ultrasound-guided jugular vein puncture......Page 128
Collateral veins......Page 129
Stepping table DSA......Page 130
Roadmap (non-subtracted fluoroscopy)......Page 131
Pixel shifting......Page 132
Masking......Page 133
The wire does not go where you expect it to......Page 135
Maintaining your position......Page 136
Single-flush technique......Page 137
Approximate positioning......Page 138
Forming a sidewinder shape catheter......Page 139
Catheter–guidewire interaction......Page 141
Microcatheters......Page 142
Key steps......Page 144
The wire crosses the lesion but the catheter will not follow......Page 145
Key steps......Page 146
Perforation......Page 147
Subintimal angioplasty......Page 148
‘Sharp recanalization’......Page 150
32 Principles of angioplasty......Page 152
Step 1: Position the balloon......Page 153
The balloon bursts during inflation......Page 154
Troubleshooting......Page 155
Dissection......Page 156
Extravasation......Page 157
Distal embolization......Page 158
General complications of arterial angioplasty......Page 159
Equipment......Page 160
Stent will not cross the lesion......Page 161
The stent comes off the balloon......Page 162
Balloon-deployed stent......Page 163
Magnetic resonance imaging (MRI)......Page 164
Solutions......Page 165
Contraindications......Page 166
Solutions......Page 167
34 Principles of pressure measurement......Page 168
Which embolic agent?......Page 170
Key steps for safe embolization......Page 171
The delivery catheter is pushed back during coil deployment......Page 172
Problems with liquid agents......Page 173
Tissue necrosis......Page 174
Key steps in retrieval procedures......Page 175
Stents......Page 176
Repositioning central venous lines......Page 177
Rendezvous, pull-through technique or ‘body flossing’......Page 178
37 Principles of vascular closure and haemostasis......Page 180
Bedrest post-angiography......Page 181
A large haematoma develops......Page 182
Active devices......Page 183
Vessel assessment......Page 184
External plugs......Page 185
Collagen plug and anchor......Page 186
Complications of manual haemostasis and vascular closure......Page 187
Contraindications......Page 188
Cutting needle biopsy......Page 189
Equipment......Page 190
Equipment......Page 191
Kidney......Page 192
Retroperitoneum......Page 193
Sample proforma for patient aftercare......Page 194
Death:......Page 195
Preparation......Page 196
Drainage catheter:......Page 197
Procedure......Page 198
Pericolic abscess......Page 199
Pelvic collections......Page 200
Aftercare......Page 202
Complications......Page 203
‘Oops I’ve accidentally kebabed the …’:......Page 204
Suitability for uterine artery embolization......Page 205
Technique:......Page 206
Procedure......Page 207
No reflux is seen:......Page 208
Outcomes......Page 209
Ultrasound-guided puncture:......Page 210
Achieving drainage:......Page 212
Transplant nephrostomy......Page 213
I’ve lost access completely (aka my assistant lost access completely):......Page 214
Procedure......Page 215
Disruption of the renal pelvis/extravasation of contrast:......Page 217
Dilating the tract:......Page 218
Which tube to leave behind?......Page 219
Complications......Page 220
Nasogastric/nasojejunal tubes......Page 221
Procedure......Page 222
Outcomes......Page 223
Percutaneous fluoroscopic gastrostomy......Page 224
How to use T-fasteners/anchors:......Page 225
Push technique......Page 226
Pull technique......Page 227
Direct percutaneous jejunostomy......Page 229
Equipment......Page 230
Technique......Page 231
The stent has migrated:......Page 232
Planning your approach:......Page 233
Blind right-sided punctures:......Page 234
Ascites:......Page 235
Extensive intraluminal filling defects are seen:......Page 236
Procedure......Page 237
Pigtail drain:......Page 238
Initial cholangiogram fades:......Page 239
Metal stents......Page 240
Procedure......Page 241
Catheterization:......Page 242
Contrast enhancement:......Page 243
General principles of RFA......Page 244
Cryotherapy......Page 246
Procedure......Page 247
Pitfalls and limitations......Page 248
Organ-specific complications......Page 249
Transarterial chemoembolization......Page 250
Radioembolization......Page 251
Procedure......Page 252
Renal cell carcinoma:......Page 253
Bronchial stent......Page 254
Superior vena cava obstruction......Page 255
Uncomplicated stenosis or occlusion:......Page 256
Equipment......Page 257
Outcomes......Page 258
Bone tumours......Page 259
Procedure......Page 260
Procedure......Page 261
Outcomes......Page 262
Equipment......Page 263
Access:......Page 264
Supplemental views:......Page 265
Arterial bypass graft imaging......Page 266
Access:......Page 267
Difficulty visualizing the graft origin......Page 268
Upper limb arterial diagnosis......Page 269
Interpretation......Page 270
Aortic arch arterial diagnosis......Page 271
Renal arterial imaging......Page 272
Catheterization:......Page 273
Unable to profile the renal artery ostia:......Page 274
Access:......Page 275
Hepatic artery imaging......Page 276
Catheterization:......Page 277
Unable to selectively catheterize the hepatic artery:......Page 278
Equipment......Page 279
Runs:......Page 280
Catheterization:......Page 282
Pulmonary vascular imaging......Page 283
Equipment......Page 284
Unable to see bronchial arteries:......Page 285
Procedure......Page 286
Failure to catheterize the pulmonary artery:......Page 287
Carotid and vertebral arterial imaging......Page 288
Carotid and vertebral artery catheterization:......Page 289
Unable to advance catheter into arch vessel:......Page 290
The external carotid artery superimposes on the internal carotid artery......Page 291
Indications......Page 292
Equipment:......Page 293
Approach......Page 294
Complications......Page 295
Equipment......Page 296
Approach......Page 297
Procedure......Page 298
Approach......Page 299
Equipment......Page 300
Indications for treatment......Page 301
Consent issues......Page 302
Equipment......Page 303
Complications......Page 304
Outcomes......Page 305
Procedure......Page 306
Outcomes......Page 308
Thrombolysis......Page 309
Equipment......Page 310
Direct prosthetic graft puncture:......Page 311
Infusion techniques......Page 312
Procedural care......Page 313
Adjunctive techniques......Page 314
Complications......Page 315
Catheterization:......Page 316
Equipment......Page 317
The device does not clear the thrombus:......Page 318
Aetiology:......Page 319
Guidance for imaging prior to endovascular repair......Page 320
What to look for?......Page 321
Aortic disease......Page 322
Configuration......Page 323
Diameters (mm):......Page 324
Durability:......Page 325
Aneurysm exclusion with a straight stent graft......Page 326
Deployment of a modular bifurcated stent graft......Page 327
There is significant narrowing of the iliac limbs in the distal aorta:......Page 329
EVAR in patients with common iliac artery aneurysms......Page 330
The patient is haemodynamically stable:......Page 331
Thoracic aorta stent-grafting......Page 332
Imaging assessment......Page 333
Consent......Page 334
Equipment......Page 335
Stent-grafting......Page 336
Balloon-assisted embolization......Page 337
Patient safety......Page 338
Radiological imaging......Page 339
Reviewing and reporting the CECT......Page 340
Blunt arterial injury......Page 341
Indications for intervention......Page 342
Aortic trauma......Page 343
Splenic trauma:......Page 344
Pelvic trauma:......Page 345
Re-bleeding......Page 346
‘Occult blood loss’......Page 347
Angiodysplasia:......Page 348
Tumour:......Page 349
Upper gastrointestinal bleeding......Page 350
Lower gastrointestinal bleeding......Page 351
Most common sources of bleeding:......Page 352
Interpretation......Page 354
Indications for treatment......Page 355
Guidance for TIPS procedure......Page 356
Approach......Page 357
Hit the hepatic artery:......Page 360
TIPS follow-up......Page 361
Bronchial and pulmonary artery bleeding......Page 362
Procedure......Page 363
The bleeding does not stop following balloon inflation:......Page 364
Haemodialysis grafts:......Page 366
Access:......Page 367
Fistulae:......Page 368
Rupture:......Page 369
Haemodialysis grafts:......Page 371
Uncertain anatomy:......Page 372
Intra-procedural thrombosis:......Page 373
Indications for IVC filtration......Page 374
Catheterization:......Page 375
Filter removal:......Page 376
Complications......Page 377
Incorrect deployment:......Page 378
Tunnelled lines:......Page 379
Procedure......Page 380
If the line is tunnelled prior to insertion into the vein:......Page 381
Dialysis lines......Page 382
Awkward venous access......Page 383
Nigh-on impossible access – keys to success......Page 384
How to strip......Page 385
