TIPS

TIPS (Transjugular Intrahepatic Portosystemic Shunt)

• Do not use Amplatz Super Stiff 145cm

• 100% Contrast (hand injection) unless the Physician states otherwise.

• Heparinized Saline 1000 ml

T table setup, MD head side, tech foot side.

Supplies

Open

• Angio pack
• Needle catheter combo
• MPB catheter
• Omni flush sizing catheter
• Micro puncture kit
• Turtle shell cover
• Probe cover (2 if needing curved probe for percutaneous access or paracentesis)
• U-pouch
• Fluoro drape
• Amplatz guide wire 180cm
• Glide wire 180cm
• Torque device (if needed)
• 8mm Occlusion balloon
• Pressure transducer
• Inflation device
• Mustang balloon (8mm 75cm or ask MD)
• Viator stent (ask MD -sterile core Pyxis)

If obtaining percutaneous access

• U/S at the head
• Green needle
• Cope wire
• Ioban or large tegaderms to secure Angio drape
• Medium tegaderm to secure wire down
• Gelfoam

If not obtaining percutaneous access

• CO2 tank
• 3-way stopcock
• (2) One way stopcock
• (2) 60cc syringes
• Pressure tubing (EdwardsLifesciences)
  • Connect pressure tubing to CO2 tank.
  • Attach 3-way stopcock at the end of the pressure tubing (sterile).
  • Test CO2 in Hep saline bowl.
  • Connect 60cc syringe with one way stopcock to 3-way stopcock.
  • Fill 60cc syringe with CO2.
  • Purge syringe in a hep saline bowl.
  • Repeat process 2x.
  • Fill syringe for the last time with CO2 then lock one way stopcock.

Paracentesis: Ask MD for Access

• Neptune machine (OR)
• Suction tubing
• Vinyl Tubing
• Yueh needle or Pigtail Yueh or Green Needle (Lynne)
• Amplatz wire
• Biliary drainage catheter (Bronzo)
• 8Fr DM only, trocar set up (Dare)

Bronzo

• Liverty Set

Splenic Percutaneous Access

• Small surgical table (left side)
• Angio pack
• Green needle
• K50 tubing
• Cope wire
• Amplatz 180cm
• Glide wire 180cm
• Bernstein catheter
• Sheath (ask Bronzo – 6Fr 30cm & 9Fr 30cm)
• Inflation device
• Mustang balloon 10x40 75cm
• 90cm Quick Cross .035

Standby

• Amplatzer Plug (kisses)
• Snare kit (Atrieve)
• .018 Steelcore 300cm
• STC Straight & Fathom wire
• 10mm Mustang balloon

Dare

• U/S at the head for Perc access & Paracentesis

Raj

• Flow switch
• No Arrow sheaths

Brittany

• Ultrasound machine on patient’s left side
• No Arrow sheaths
• Nitrex guidewire (also for Perc access)
• Colapinto Needle
• Gelfoam with contrast (Perc access closure)
• Mustang Balloons 6mm & 8mm

Evan

• Micropuncture kit (Cook)

Samir

• Liverty set
• 10Fr dilator

Lynne

• Flow switch
• C2 catheter on standby
• Nitrex guidewire
• TIPS sheath (10Fr)
• Liverty Set
• 8mm balloon and up