Intervential Radiology Flashcards
Image-guided interventions:
- Drainage
- Biopsy
- Enteral Access
- Vascular Access
- Vascular Interventions
When is drainage used? What is commonly used with drainage?
- Fluid
- Abscess
- - Abx are adjunctive
When do you want to drain pleural fluid?
- Loculated Empyema
- Simple Effusion
** Drainage may provide relief of symptoms but does not necessarily treat the underlying cause
Methods of Drainage:
- Blind Percutaneous (Auscultate and know your anatomy)
- Image-based (CT or US)
***Situation can dictate which one is used
Pros and Cons of image guided drainage?
Pros: More precision for loculated fluid collection
Cons: Perforation/Anatomy
What type of abscesses would potentially need image guided drainage?
Deep Tissue Abscess
Why do we use biopsies?
- Less morbidity
- More accurate
Why do we breast biopsy?
- Need adequate tissue for dx
- Minimal scarring/disfurement
- allows for further therapy/re-excision
When would you do enteral access procedures?
- Feeding access
- Decompression
- Gastric Access
What are the two types of enteral access?
- Gastrostomy
- PEG
What is new-school vascular access?
Image guided techniques – more safe and more accurate
What is old school vascular access?
Use of only anatomic land marks
What does central access me?
IV with tip of catheter in a central vein like the internal jugular
What is a negative effect of central vascular access?
- TPN
Examples of Vascular Interventions
- Diagnostic
- Angioplasty/Stent for occlusive dz
- Embolization
- Tx of Aneurysmal Dz
- Dz Prevention
Angiography?
- Take digital subtraction angiography
- Uses intra-arterial contrast
- Manipulates wires and catheters to areas of pathology
What is the Seldinger Technique
Insert needle into femoral artery, place wire through needle, remove needle, place larger sheath/catheter over wire
When is an embolization done?
Bleeding!!
- Pelvin/Splenci bleeding in trauma
- Occult GI Hemorrhage
- Uterine Fibroids
Can also inject chemicals: Intra-arterial chemotherapy for liver tumors
What are IVC Filters and why are they used?
- Devices placed into the IVC in certain high risk patient populations to decreased incidence of fatal PE.
How is an IVC Filter put in?
Placed through access of large vein (IJ, femoral) under US or fluoroscopy.
Are IVCs removable?
Yes
