Embolization: Difference between revisions

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(Created page with "EMBOLIZATION *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 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 contra...")
 
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EMBOLIZATION
{{Warn|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  
*CONFIRM WITH PHYSICIAN REGARDING CATHETERS AND USE OF INJECTOR*
*100% Contrast (hand injection) unless the Physician states otherwise.  
 
***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  
*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)


Angio pack
==Emobolization methods==
===Coils===
*Detacher – If using Concerto coils


Gloves
===Coil Deployment Steps===
 
#Make sure the introducer sheath is nice and hubbed (seated) in microcatheter.
Fluoro drape
#Take orange lock off – discard
 
#Start advancing wire  
U/S Prober cover
#Remove sheath with 5-10cm left
 
#Save sheath just in case you want to recapture coil
Turtle shell cover
#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.
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)
 
 
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:
 
Flow switch
 
Bentson guidewire
 
Shape guidewire himself
 
Hummingbird technique (cut micro puncture dilator and attach to 20cc Hep saline syringe)
 
Extra Prep stick (closure)
 
Mynx
 
Omniflush (Postpartum Bleed)
 
 
 
BRITTANY:
 
Starclose
 
Always set up Injector
 
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:
 
Flow switch
 
Hummingbird technique (cut micro puncture dilator and attach to 20cc Hep saline syringe)
 
Bentson guidewire
 
C2 catheter
 
SOS 2 (standby)
 
2.0 Fr True Select
 
2.4 Fr Microcatheter (standby)
 
Synchro Soft guidewire
 
Extra Prep stick (closure)
 
Mynx


   
   
 
===ONYX Liquid Embolic System===
COILS
*Onyx 18 or Onyx 34 (Neuro cart)
 
*Shaker machine (Neuro cart)
Detacher – If using Concerto coils
*Need a clean surface or extra table
*New gloves
*(2) 18G needles, one for drawing up Onyx and one for drawing up DMSO


   
   


ONYX Liquid Embolic System
===Obsidio===
 
*EP Fridge (Sterile core)   
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)   


   
   
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*700 – 900  
*700 – 900  
*(2) 1cc White Medallion syringe, for bead injection  
*(2) 1cc White Medallion syringe, for bead injection  
**(2) 10cc syringes with contrast (100%)  
*(2) 10cc syringes with contrast (100%)  
*3-way stopcock  
*3-way stopcock
 


===Trufil Glue===
===Trufil Glue===
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*¾ sheet (if using a separate table)  
*¾ sheet (if using a separate table)  
*5% Dextrose 500ml saline bag  
*5% Dextrose 500ml saline bag  
Blue bowl  
*Blue bowl  
**Medicine cup (Overstock cart – sterile core)  
*Medicine cup (Overstock cart – sterile core)  
*Gloves  
*Gloves  
*(2) White 1cc medallion syringe  
*(2) White 1cc medallion syringe  
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*(3) 3cc syringes  
*(3) 3cc syringes  
*(3) 6cc syringes  
*(3) 6cc syringes  
*(2) 18G needle
*(2) 18G needle


===GEL FOAM ===
===GEL FOAM ===
*Pharmacy cart (ask RN)  
*Pharmacy cart (ask RN)  
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EMBOLD STEPS:
==Bronzo==
#Make sure the introducer sheath is nice and hubbed (seated) in microcatheter.
*SOS2 80cm catheter
#Take orange lock off – discard
*STS Straight Microcatheter
#Start advancing wire  
*Hummingbird technique (Insertion tool attach to 20cc Hep saline syringe)
#Remove sheath with 5-10cm left
*Starclose (ask)
#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.
 
==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
 
[[Category:IRProcedures]]

Latest revision as of 22:46, 5 November 2024

Note 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

  1. Make sure the introducer sheath is nice and hubbed (seated) in microcatheter.
  2. Take orange lock off – discard
  3. Start advancing wire
  4. Remove sheath with 5-10cm left
  5. Save sheath just in case you want to recapture coil
  6. Dr takes over and when happy with coil – snap and pull two white markers on back end
  7. 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

Note 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
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