Interventional procedures Flashcards
needle gauge
-the smaller the gauge number the bigger the needle core (opening)/ the bigger the gauge number the smaller the needle core
cyst aspiration
-cystic lesions that have thick walls and other suspicious features
-symptom relief
-eliminate mammographic masses
-cytology fluid evaluated only if color is suspicious (if not, discarded in sharps container)
abscess drainage
-pt with an infection fluid collection that is not responding to antibiotic treatment (may have to be repeated)
fine needle aspiration (FNA)
-local anesthetic applied
-fine needle (18-25 gauge) used to aspirate cell
-cytotechnologist preps sample and places cell on a glass slide (multiple passes may be needed)
-U/S guided FNA done on irregular lymph nodes with thickened cortex
-yields CYTOLOGIC evaluation of CELLS
FNA advantages
-less invasive than core biopsy
-local anesthesia may be used
-safe, minimal complications
-usually on lymph nodes breast/axilla
-results in <1-2 hrs
FNA disadvantages
-possible false neg. b/c of small sample size
-cytologic eval doesn’t differentiate in situ from invasive cancers
-not used for sampling microcalcifications
Ultrasound core biopsy
-US guidance only
-solid lesions with other suspicious features
-lesions near chest wall
-pts with bleeding or clotting disorders where vacuum assistance may be contraindicated (not recommended)
US core biopsy technique
-14-16 gauge core biopsy needle in a spring loaded design with a trough
-3-5 passes (US used to guide)
core biopsy advantages
-less invasive than open surgical biopsy
-small incision and local anesthetic
-sample volume is sufficient for HISTOLOGIC (tissue) eval
core biopsy disadvantages
-risk of bleeding, infection or hematoma
-dense lesions are difficult to sample
-histologic analysis usually req. a min. of 24 hrs
vacuum-assisted core biopsy (VAAB
vacuum-assisted breast biopsy (VABB)
-Indications;
-solid lesions with other suspicious features should be biopsied
-7-14 gauge automated sampling system
-after local anesthesia, 1/4 in. skin incision made
-needle enters lesion once, sampling notch is rotated
-common type of image guided biopsy; stereotactic, US, MR, and Tomo
Vacuum assisted core biopsy stereotactic guidance used for what?
suspicious calcification
vacuum assisted core biopsy advantages
-less invasive than surgical bx, local anesthetic
-greater accuracy sampling dense masses
-vacuum assisted- one needle pass
-small lesions may be completely excised
-HISTOLOGIC (tissue) samples
-less cost
vacuum assisted core biopsy disadvantages
-greater risk of bleeding, infection, hematoma, or other complications
-healthy tissue may be compromised
clip placement
-can be placed after US, MR, stereotactic, or DBT breast biopsy
-safe, minimal complication
why do we do clip placement?
-necessary to place clip during biopsies in order to continue surveillance of the area on images on the pt in years following
-if area needs to be surgically removed, then clip will be removed too
post procedure imaging views to verify clip placement
-breast; CC, MLO
-axilla; AT, AP shoulder
wire localization (needle localization) indications
-placement of percutaneous needle wire for pre-operative guidance in locating;
-biopsy proven breast cancer or high-risk lesion
-non-palpable breast lesion
-wire guides surgeon to the mass (can be done w/ US or mammo)
post procedure mammogram
wire localization
-after wire localization, CC & ML or MLO are taken to assess wire placement
-following localization using a hook wire, pt is taken to surgery
-surgeon removes wire along with surrounding breast tissue
specimen radiography
-xray of specimen is taken to assure that the area of interest and/or clip is in the excised tissue
-specimen sent to pathology lab for examination and interpretation
seed placement
-wire free breast localization system
-size of a grain of rice
-non-radioactive; magseed SAVI SCOUT
-radioactive; I125 seed
post procedure imaging
verify seed placement
-breast; CC, ML
-axilla; AT, AP shoulder
OSHA
occupational safety and health administration created in 1970
biohazardous waste (medical waste)
waste that has risk of carrying infectious diseases (needles, glass, blades)
infectious material
human bodily fluids, blood or unfixed tissue (to the body)
universal precautions
an approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV, and other bloodborne pathogens
