Non-Tunneled + Tunneled Hemodialysis Catheter
- Ultrasound unit + Probe cover
- Small Tray
- Micropuncture set
- Short amplatz wire (Some physicians) Small J wire (Other Docs)
- Dilators 8/10F
- Soft silk suture
- Lidocaine in control top syringe
- Heparin 1000 Units/cc
- Heparinized Saline
- Some physicians uses a ruler, dermabond and steristrips with tunneled HD catheter placement
Triple Lumen Catheter – Non Tunneled
- Ultrasound unit + Probe cover
- Triple lumen kit (contains dilator and J wire)
- Soft silk suture
- Lidocaine in control top syringe
- Heparin 100Units/cc
- Saline
Note: when passing catheter over wire for placement leave red lumen open. Prime white and blue ports with heparinized saline
Broviac – Tunneled small bore central venous catheter
- Ultrasound unit + Probe cover
- Small tray/small drape
- Micropuncture set
- Broviac Catheter (single or double)
- Soft silk suture
- Lidocaine in control top syringe
- Heparin 100Units/cc
- Hep Saline
- Some physicians uses steri strips and dermabond, Some physicians also use a glow switch
Tunneled Catheter removal
- Medium Drape
- Large laceration tray which includes 27G needle
- Control top syringe for lido
- Labels
- 4 x 4 gauze pack
- Blue towels
- Chloro prep
- Tegaderm
RFA – Saphenous vein ablation
- Ultrasound unit + Probe cover
- Large tray
- Micropuncture set
- Tumecent from inpatient pharmacy (Take RFA requisition to inpt pharmacy at least 2 hrs prior to appt)
- Saline
Venaseal – Saphenous vein ablation
- Ultrasound unit + Probe cover
- Large tray
- Micropuncture set
- Saline
- Control top syringe for lido
IVC filter placement
- Ultrasound unit + Probe cover
- Small tray
- Control top syringe for lido
- Micropuncture set
- Contrast
- Heparinized saline
- Bentson
Tunneled Central Line Exchange with Possible revision
- 1 Stiff angled 180cm Glide wire
- Large tray or small tray and a curved kelley from suture removal kit
- Control top syringe for lido
- Soft silk suture
- New hemodialysis catheter
- Heparin 1000 Units/cc
- Heparinized saline
- Possibly will need (10 or 11 F sheath, Contrast, 12mm Balloon)
AV fistulagram
- Ultrasound unit + Probe cover
- 5ml of 1000units per cc heparin
- K50 Tubing
- Small tray
- Large drape
- Micropuncture set
- Hep saline
- 100ml contrast
- 1 x 6F short sheath open (have a second one ready but not open)Â
- Control top syringe for lido
- Micropuncture set
- Flow switch
- Nitrix (Every Day wire)
- 3-0 stitch
- May ask for Kumpe Catheter 65cm (some physicians use glidewire and glidecath)
- If intervening may need (Insufflator (Some physicians hand inflates), balloon, stents…)
AV fistula declot
- Ultrasound unit + Probe cover
- 5ml of 1000units per cc heparin
- K50 Tubing
- Large tray + Small laceration kit for cissors
- Large drape
- Micropuncture set + (Entry needle 18G x 4cm for some doctors)
- Hep saline
- 100ml contrast
- 2 x 6F short sheath openÂ
- Control top syringe for lido
- 5mm fogarty balloon
- Flow switch
- Nitrix (Every Day wire)
- Two 3-0 stitch
- TPA
- Insufflator open on table (some doctors hand inflates)
- Kumpe Catheter 65cm open on table
- Teratola (Open if asked for)
- If intervening may need ( balloon, stents…)
Vertebroplasty
- Small tray
- Chiba needle
- Avamax
- 30ml lidocaine
- Hep saline
- (extension tubing for numbing)
Nephrostomy tube placement
- Good Ultrasound unit + Probe cover
- Small tray
- Accu-stick
- Nitrex wire (every day wire)
- Bentson
- Chiba needle
- Control top syringe for lido
- Dr. may ask for 4F kumpe catheter
- 8F Nephrostomy tube and Uresil bag
Nephrostomy tube Exchange
- Control top syringe for lido
- Small tray
- Large Drape
- Contrast
- Bentson Wire
- 8F Nephrostomy tube and Uresil bag
Double J stent placement When pt already has a Nephrostomy tubeÂ
- Small Tray
- 5F Kumpe Catheter
- Bentson and glidewire
- Peel away sheath
Lower extremity or other arterial (Splenic) Angiogram
- Ultrasound unit + Probe cover
- Large tray
- Micropuncture set
- Hep saline (Some physicians uses heparinized flush to attach and drip into access sheath)
- 100ml contrast
- 6F 10cm SheathÂ
- Control top syringe for lido
- Power injector tubing
- Flow switch
- Bentson, Angled glidewire
- some physicians use 90cm pigtail catheter Some physicians uses Ominiflush
- If intervening may need ( Straight flush, navicross, road runner, 45cm sheath, rosen…)
- Minx closure, Angioseal or Starclose
Splenic Artery Angiogram and Embolization
- Same as above but add MicrocatheterÂ
- Possible coils
- 3cc seringes – 6 total with 3 marked contrast and 3 marked hep saline
Uterine fibroid embolization
- Ultrasound unit + Probe cover
- Large tray
- Micropuncture set
- Hep saline (Some physicians uses heparinized flush to attach and drip into access sheath)
- 100ml contrast
- 6F 10cm Sheath openÂ
- Control top syringe for lido
- Flow switch
- Bentson 180, Angled glidewire 180
- Open RUC catheter and MicrocatheterÂ
- Some physicians use Angiodynamics Cobra 2 Some physicians/Other physicians use Ominiflush
- 3cc syringes for microcatheter
- Minx closure, Angioseal or Starclose
Transjugular Liver Biopsy
- Ultrasound unit + Probe cover
- Small tray
- Micropuncture set
- 50ml contrast
- Control top syringe for lido
- Transjugular liver biopsy kit
- Bentson 180
- 9F 30cm Sheath
- Dilators 7/8/10
IVC Filter Placement
- Ultrasound unit + Probe cover
- Small Tray
- Large Drape
- 50cc Contrast
- Control top syringe for lido
- Micropuncture set
- Argon Option Elite Filter Kit
IVC Filter Removal
- Ultrasound unit + Probe cover
- Micropuncture set
- Filter removal kit
- Small Tray
- Large Drape
- Control top syringe for lido
- Bentson wire
- Flow Switch
- Pigtail. Some physician do not use pigtail
Groin Pseudoaneurysm.
- Ultrasound unit + Probe cover
- Small Drape
- Towels
- Laceration kit
- Control top syringe for lido
- Micropuncture set
- Gauze pack
- Chloraprep
- 3 way stop cock
- 1 cc syringe (Additional 3 cc syringes)
- Thrombin medication kit
Ultrasound Guided Biopsy
- Ultrasound unit + Probe cover
- Medium drape
- Towels
- Control top syringe for lido
- Biopsy Tray from CT
- If 18 gauge core bx open appropriate length biopence and matching introducer
- If smaller 20 gauge core bx open appropriate length Bard
- For liver and kidney bx open Gelfoam/3 way stop cock/ 2x 5cc seringes
- For livers and kidney bx Some physicians uses a 10cm 22 gauge chiba needle
Frequently Asked Questions
What equipment is needed for a hemodialysis catheter procedure?
For a hemodialysis catheter procedure, essential equipment includes an ultrasound unit with a probe cover, a small tray, a micropuncture set, dilators, and soft silk suture. Lidocaine is used for local anesthesia, and heparinized saline is necessary to prevent clotting. Depending on the type of catheter (non-tunneled or tunneled), additional items like a short amplatz wire or a triple lumen kit might be required.
Why is an ultrasound used in interventional radiology procedures?
An ultrasound is used in interventional radiology (IR) procedures to provide real-time imaging guidance. This helps physicians accurately locate blood vessels and other anatomical structures, improving the precision and safety of procedures like catheter placements, biopsies, and venous ablations.
What is a micropuncture set, and why is it important in IR procedures?
A micropuncture set is a kit used for accessing blood vessels with minimal trauma. It typically includes a small-gauge needle, guidewire, and introducer sheath. This set is crucial in IR procedures to create a safe and precise entry point into the vasculature, reducing the risk of complications and improving patient outcomes.
How is lidocaine used during IR procedures?
Lidocaine is a local anesthetic used during IR procedures to numb the area where the procedure is performed. It is typically administered through a control top syringe, ensuring patient comfort by minimizing pain and discomfort during needle insertion or catheter placement.
What is the purpose of using heparin in interventional radiology?
Heparin is an anticoagulant used in interventional radiology to prevent blood clotting during procedures. It is often mixed with saline to create heparinized saline, which is used to flush catheters and other devices, ensuring they remain patent and preventing thrombus formation in the blood vessels.
What is the role of a soft silk suture in catheter placement?
A soft silk suture is used to secure catheters in place after insertion, preventing accidental dislodgement. This is particularly important for tunneled catheters, where stability is crucial to maintain proper function and reduce the risk of infection or mechanical complications.
When is a tunneled catheter typically used over a non-tunneled one?
A tunneled catheter is used when long-term vascular access is needed, such as for ongoing hemodialysis. It is placed under the skin and tunneled to a blood vessel, providing a more secure and stable option than non-tunneled catheters, which are generally used for short-term access.
What are steri-strips and dermabond used for in IR procedures?
Steri-strips and Dermabond are used in IR procedures to close and secure small incisions. Steri-strips are adhesive strips that support wound closure, while Dermabond is a liquid adhesive that acts like surgical glue. Both help promote healing and reduce infection risk without traditional sutures.