- Celiac axis angiogram
- ___hepatic artery angiogram
- Radioembolization of the hepatic artery
- Right common femoral artery angiogram
- Arteriotomy closure with Starclose
MEDICATIONS: Versed mg IV, fentanyl mcg IV, Ancef 1 gram IV; Premedications given per protocol.
CONTRAST: ml of nonionic contrast
FLUORO TIME: minutes
ACCESS SITE: Right common femoral artery
The risks, benefits, and alternatives to the procedure and sedation were explained to the patient, and written informed consent obtained.
The patient was placed in supine position on the angiography table and right groin was prepped and draped in sterile fashion. The skin and subcutaneous tissue overlying the right common femoral artery were infiltrated with 2% lidocaine for local anesthetic. Using ultrasound guidance, the right common femoral artery was punctured using a micropuncture needle. A 0.018″ wire was advanced through the needle into the artery. The needle was exchanged for a 5 French transitional catheter. The inner dilator and the 0.018″ wire were removed and a 0.035″ Bentson wire was advanced into the artery. The transitional catheter was exchanged for a 5 French vascular sheath, which was attached to a heparinized pressure bag of normal saline. A 5 French Sim-I Glidecath was advanced over the wire and was used to cannulate the celiac axis. Digital subtraction angiography was performed.
A Renegade Hi-Flo microcatheter was coaxially loaded and advanced over a 0.014″ Transend guidewire into the hepatic artery and a corresponding arteriogram was obtained.
Once the catheter was in adequate position, approximately mCi of 90-Yitrium radioactive particles ( were infused into the hepatic artery. The microcatheter was flushed and the catheters were disposed of appropriately.
A right common femoral angiogram was obtained through the sheath. The sheath was removed and the arteriotomy was closed with a StarClose device. A sterile dressing was applied.
The patient tolerated the procedure well and left the angiography suite in stable condition without any immediate postprocedural complications.
- Celiac angiogram demonstrates conventional anatomy. Embolization coils are again noted in the mid gastroduodenal artery and there is no distal filling.
- hepatic artery angiogram demonstrate multiple hypervascular lesions in the hepatic lobe.
- Limited right common femoral arteriogram demonstrates arterial access above the femoral bifurcation and below the deep inferior epigastric artery, adequate for closure device.
IMPRESSION: Successful radioembolization of the hepatic lobe utilizing .