Interventional Radiology A Survival Guide 4th Edition by Iain Robertson,David Kessel 9780702068898 0702068896

Section 1 Core Interventional Skills

1 Planning safe procedures

Making the correct treatment plan

Preparing for successful and safe procedures

Patient preparation

Managing high-risk patients

The patient’s general condition

2 Pre-procedure safety check

Advance planning

On the day: staff, equipment and room preparation

Post-procedure check and aftercare

3 Contrast

Intravascular X-ray contrast agents

Basic principles for using intravascular contrast

MRI contrast agents

Negative contrast agents – carbon dioxide (CO2)

4 Sedation

Conscious sedation

To sedate or not to sedate, that is the question

Sedation guidelines

Patient selection

Care and monitoring of sedated patients

Aftercare

5 Pain control and analgesia

Pain control – forward planning

Patient-controlled analgesia

6 Recognition and management of complications

Complications

Seeking assistance

Post-procedure debrief

Discussion with patients

Documentation of complications

Learning from complications

7 The interventional radiology clinic

The roles of the clinic

Section 2 Essential Equipment

8 Essential equipment: Puncture needles

Purpose

Description

Know what to ask for

Know how to use it

9 Essential equipment: Biopsy needles

Purpose

Description

Know how to use it

Know what to ask for

Know how to use it

10 Essential equipment: Access kits

Purpose

Description

Know what to ask for

Know how to use it

11 Essential equipment: Guidewires

Purpose

Description

Know what to ask for

Know how to use it

12 Essential equipment: Catheters

Purpose

Description

Know what to ask for

Know how to use it

13 Essential equipment: Microcatheters

Purpose

Description

Know what to ask for

Know how to use it

14 Essential equipment: Sheaths and guide catheters

Sheaths

Vascular sheaths

Know what to ask for

Know how to use it

Peel away sheath

Know what to ask for

Know how to use it

Guide-catheters

Know what to ask for

Know how to use it

Introducer guides

Know how to use it

15 Essential equipment: Taps, hubs and connectors

Taps

Haemostatic seals

Connectors

16 Essential equipment: Pump injectors

Purpose

Description

Know what to ask for

Know how to use it

17 Essential equipment: Snares

Purpose

Description

Know what to ask for

Know how to use it

18 Essential equipment: Angioplasty balloons

Purpose of equipment

Description

Know what to ask for

Know how to use it

19 Essential equipment: Inflation handles

Purpose

Description

Know what to ask for

Know how to use it

20 Essential equipment: Stents

Purpose

Description

Know what to ask for

Know how to use it

21 Essential equipment: Stent grafts and covered stents

Purpose

Description

Know what to ask for

22 Essential equipment: Inferior vena caval filters

Purpose

Description

Know what to ask for

Know how to use it

23 Essential equipment: Embolization

Essential equipment

Particulate embolic agents

Liquid embolic agents

Temporary embolic agents

Autologous blood clot

24 Essential equipment: Drainage catheters

Purpose

Description

Know what to ask for

Know how to use it

25 Essential equipment: Ureteric stents

Purpose

Description

Know what to ask for

Know how to use it

Section 3 Principles of Intervention

26 Principles of imaging guidance for intervention

Ultrasound guidance

Computed tomography guidance

Fluoroscopic guidance

27 Principles of good fluoroscopy and radiation protection

Fluoroscopy

A guide to good fluoroscopy

28 Principles of vascular access

Arterial puncture

Venous puncture

29 Principles of diagnostic angiography

Digital subtraction angiography: basic principles

Digital subtraction angiography techniques

Reaching the target: catheter guidance

Dose reduction

Archives and imaging

30 Principles of using catheters and wires

Advancing the guidewire

Advancing a catheter over a guidewire

Catheter and guidewires: advanced techniques

Catheters

Catheter–guidewire interaction

31 Principles of crossing stenoses and occlusions

Crossing stenoses

Crossing occlusions

32 Principles of angioplasty

Equipment

Key steps

Assessing the angioplasty site

Assessing the distal vessels

General complications of arterial angioplasty

33 Principles of stenting and stent-grafting

Equipment

Key steps in stenting

Covered stents

Stent-grafting for aneurysmal disease: basic rules

34 Principles of pressure measurement

35 Principles of embolization

General principles

Which embolic agent?

Key steps for safe embolization

Troubleshooting

Complications

36 Principles of rendezvous and retrieval procedures

The toolkit

Clinical scenarios

Key steps in retrieval procedures

37 Principles of vascular closure and haemostasis

Manual haemostasis: how to prevent haemorrhage and haematoma

Arterial closure devices

Complications of manual haemostasis and vascular closure

Section 4 Intervention

38 Achieving tissue diagnosis

Pre-procedure

Biopsy – specific sites

Aftercare

Complications

39 Treating fluid collections and abscesses

Pre-procedure planning

Specific sites

Aftercare

Troubleshooting

Complications

40 Treating urogenital vascular conditions

Uterine artery embolization

Testicular vein embolization

Ovarian vein embolization

41 Treating urological conditions

Nephrostomy

Antegrade ureteric stent

Percutaneous nephrolithotomy

42 Treating gastrointestinal conditions

Nasogastric/nasojejunal tubes

Oesophageal fistulae and perforations

Gastric outlet and duodenal stents

43 Treating biliary obstruction

Percutaneous transhepatic cholangiography

Percutaneous biliary drainage

Percutaneous gallbladder drainage

Roux loop access

44 Treating cancer

Treating tumours

Liver tumours

Renal tumours

Thoracic system

Bone tumours

45 Achieving angiographic diagnosis

Diagnostic digital subtraction angiography

Lower limb arterial diagnosis

Arterial bypass graft imaging

Upper limb arterial diagnosis

Aortic arch arterial diagnosis

Renal arterial imaging

Renal transplant artery imaging

Hepatic artery imaging

Mesenteric arterial imaging

Gastrointestinal bleeding

Mesenteric ischaemia

Pulmonary vascular imaging

Bronchial artery imaging

Pulmonary artery imaging

Carotid and vertebral arterial imaging

46 Treating arterial occlusive disease

Basic principles

Treating arterial occlusive disease at specific sites

47 Treating acute limb ischaemia

Thrombolysis

Thrombosuction

Mechanical thrombectomy

48 Treating aneurysmal disease

Aneurysm terminology

When to treat aneurysms?

Guidance for imaging prior to endovascular repair

Aortic disease

Specific consent issues

Aneurysm exclusion with a straight stent graft

Troubleshooting

Aorto-uni-iliac systems

Thoracic aortic aneurysms, aortic trauma and acute aortic syndromes

Acute aortic syndromes

Renal and visceral aneurysms

Stent-grafting

Stent-assisted coiling

Balloon-assisted embolization

49 Treating haemorrhage

General principles

Specific clinical scenarios

Variceal haemorrhage: transjugular intrahepatic portosystemic shunt and other techniques

Bronchial and pulmonary artery bleeding

50 Treating haemodialysis access

Permanent dialysis access

Dialysis access imaging

Angioplasty and stenting

Thrombosis

51 Treating venous disease

IVC filters

Iliac vein obstruction

Venous lines

Maintenance of tunnelled central lines

How to strip

Suggestions for further reading