Left Subclavian IABP: Difference between revisions
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Romick | |||
Left subclavian iabp | |||
''' | '''if left subclavian is occluded or otherwise inaccessible procedure is aborted. Iabp should not be inserted through right subclavian per ct surgery.''' | ||
= | = equipment = | ||
* | * micropuncture | ||
* (2) 4/ | * (2) 4/5f slender radial sheath | ||
* | * amplatz extra stiff 260cm wire | ||
* .035 | * .035 150cm jwire | ||
* | * 5f pigtail catheter | ||
* | * 5f jr4 diagnostic catheter | ||
* | * iabp kit | ||
* | * 8f 23cm safesheath (ep) | ||
* | * perclose | ||
* | * tr band | ||
= | = procedure = | ||
* | * prep left side neck and chest (ear to nipple and shoulder to midline) | ||
** ''' | ** '''note:''' the access site is not an absolute (may become axillary or subclavicular) hence the large site prep. | ||
* | * prep left radial | ||
* | * left radial accessed and 4/5f slender sheath inserted | ||
* | * pigtail advanced and angiogram performed. Pigtail left in place and used as reference for subclavian access. | ||
* | * subclavian accessed with ultrasound and fluoro guidance using micropuncture kit and radial sheath inserted. | ||
* | * pigtail catheter removed | ||
* | * j wire and jr4 inserted and directed to descending aorta. | ||
* | * catheter and sheath removed, 8f dilator inserted, and perclose advanced for pre-closure | ||
* | * amplatz wire advanced, perclose removed, 8f safe sheath advanced. | ||
* | * iabp inserted | ||
* | * sheath peeled away | ||
* | * iabp secured with suture and site dressed. | ||
* | * radial sheath removed and tr band applied | ||
</br> | </br> | ||
[[ | [[category:procedures]] | ||
< | <hr> | ||
Approved: md initials mm/yy | |||
Revision as of 19:06, 10 October 2019
Romick
Left subclavian iabp
if left subclavian is occluded or otherwise inaccessible procedure is aborted. Iabp should not be inserted through right subclavian per ct surgery.
equipment
- micropuncture
- (2) 4/5f slender radial sheath
- amplatz extra stiff 260cm wire
- .035 150cm jwire
- 5f pigtail catheter
- 5f jr4 diagnostic catheter
- iabp kit
- 8f 23cm safesheath (ep)
- perclose
- tr band
procedure
- prep left side neck and chest (ear to nipple and shoulder to midline)
- note: the access site is not an absolute (may become axillary or subclavicular) hence the large site prep.
- prep left radial
- left radial accessed and 4/5f slender sheath inserted
- pigtail advanced and angiogram performed. Pigtail left in place and used as reference for subclavian access.
- subclavian accessed with ultrasound and fluoro guidance using micropuncture kit and radial sheath inserted.
- pigtail catheter removed
- j wire and jr4 inserted and directed to descending aorta.
- catheter and sheath removed, 8f dilator inserted, and perclose advanced for pre-closure
- amplatz wire advanced, perclose removed, 8f safe sheath advanced.
- iabp inserted
- sheath peeled away
- iabp secured with suture and site dressed.
- radial sheath removed and tr band applied
Approved: md initials mm/yy
