Embolization
From Bay Area Structural Heart Wiki
Warning: CONFIRM WITH PHYSICIAN REGARDING CATHETERS AND USE OF INJECTOR
- Injector set up 100% contrast for Dr Olorunsola. The rest of the MD’s are 50/50
- 100% Contrast (hand injection) unless the Physician states otherwise.
- Heparinized Saline 1000 ml
Open
- Angio pack
- Gloves
- Fluoro drape
- U/S Prober cover
- Turtle shell cover
- 5Fr x 11cm sheath
- 3-way stopcock
- Tuohy
- 3cc Blue Medallion syringe
- (2) Green or Purple Medallion syringe for contrast
- 3J x 145cm guidewire
- Glide wire 180cm
- Fathom Guidewire
- Torque Device (if needed)
- One way or blue cap
- (2) 12cc syringe
- RIM (Postpartum bleed)
- RBT catheter (Postpartum bleed)
Emobolization methods
Coils
- Detacher – If using Concerto coils
Coil Deployment Steps
- Make sure the introducer sheath is nice and hubbed (seated) in microcatheter.
- Take orange lock off – discard
- Start advancing wire
- Remove sheath with 5-10cm left
- Save sheath just in case you want to recapture coil
- Dr takes over and when happy with coil – snap and pull two white markers on back end
- Check under fluoro that coil is fully out of microcatheter and that nothing moves when you go to deploy.
ONYX Liquid Embolic System
- Onyx 18 or Onyx 34 (Neuro cart)
- Shaker machine (Neuro cart)
- Need a clean surface or extra table
- New gloves
- (2) 18G needles, one for drawing up Onyx and one for drawing up DMSO
Obsidio
- EP Fridge (Sterile core)
Embospheres
Protip: Make sure to let the beads settle against the plunger before wasting extra liquid
- 100 - 300
- 300 – 500
- 500 – 700
- 700 – 900
- (2) 1cc White Medallion syringe, for bead injection
- (2) 10cc syringes with contrast (100%)
- 3-way stopcock
Trufil Glue
- Clean surface or extra table
- ¾ sheet (if using a separate table)
- 5% Dextrose 500ml saline bag
- Blue bowl
- Medicine cup (Overstock cart – sterile core)
- Gloves
- (2) White 1cc medallion syringe
- (2) 20cc syringes
- (3) 3cc syringes
- (3) 6cc syringes
- (2) 18G needle
GEL FOAM
- Pharmacy cart (ask RN)
- 3-way stopcock
- 10cc syringe
- 6cc syringe
- 3cc Medallion syringe
- Postpartum Bleed – 20cc syringe with 7ml of contrast attach to 10cc syringe with gel foam (mix)
Bronzo
- SOS2 80cm catheter
- STS Straight Microcatheter
- Hummingbird technique (Insertion tool attach to 20cc Hep saline syringe)
- Starclose (ask)
Dare
- Cobra2 75cm catheter
- Hi-Flo Microcatheter
- Closure device (ask)
Raj
- Shape guidewire himself
Open
- Flow switch
- Bentson guidewire
- Hummingbird technique (cut micro puncture dilator and attach to 20cc Hep saline syringe)
- Extra Prep stick (closure)
- Mynx
- Omniflush (Postpartum Bleed)
Brittany
- Always set up Injector
Open
- Starclose
- C2 catheter (for Liver Embo)
- Renegade HiFlo micro catheter
- Fathom wire
- Extra Prep stick for closure
- Extra gloves for closure
Evan
- Micropuncture kit (Cook)
Samir
Lynne
Open
- Flow switch
- Hummingbird technique (cut micro puncture dilator and attach to 20cc Hep saline syringe)
- Bentson guidewire
- C2 catheter
- 2.0 Fr True Select
- Synchro Soft guidewire
- Extra Prep stick (closure)
- Mynx
Standby
- 2.4 Fr Microcatheter
- SOS 2