Endovascular embolization of a thigh bleeding procedure скачать в хорошем качестве

Endovascular embolization of a thigh bleeding procedure

#interventionalradiologypills #interventionalradiology #IRadiology #Elderly patients have an increased overall risk of #bleeding usually associated with the use of anticoagulant and anti-platelet agents. The triggering event is often not identifiable due to a reduced patient compliance, which favors the risk of a diagnostic delay and a dramatic evolution of the patient clinical status. Surgical approach is usually not feasible as the consequence of patients’ comorbidities and fragility. In this scenario, #interventionalradiology is the full master of the management of these patients. #Endovacular management is safe and does not require general anesthesia if patient is clinically stable and collaborative. DIAGNOSTIC WORKUP Angiographic-CT is the imaging test of choice in patients with suspected bleeding. Basal acquisition is performed for the identification of the hematoma. Arterial, Portal and Venous phase are subsequently performed in order to identify the bleeding vessel. PROCEDURAL STEPS AND TECHNIQUE Vascular access is performed usually at the common femoral or radial artery site. Pain control is achieved with local anesthesia. Vessel puncture is performed at free-hand or under ultrasound/fluoroscopic guidance with a 18G cannula. Once the needle is in the vascular lumen a guidewire is passed through the needle and an arterial vascular sheath is finally placed in the artery. On the basis of the CT examination a diagnostic catheter is placed in large vessel as near as possible to the suspected bleeding vessels. A diagnostic angiography run is performed and bleeding site is usually identified. A microcatheter is moved to the site of bleeding and embolization is performed with the most appropriate embolic agent (Coils, Glue, PVA, Gelfoam, Plug, Stent, ecc…). A final diagnostic angiographic run confirms the bleeding cessation. Bibliography: www.ncbi.nlm.nih.gov/pubmed/25388991 www.ncbi.nlm.nih.gov/pubmed/16224920 #radiology #IReducation #IRresident #medicine #IRprocedure #IRvideo #IRcase #interventionalradiologylife #ODIR #topIR #dreamIR #standardofcare #radiologiainterventistica #newfrontiers #interventionalnews #medicalnews #IRaddiction #poetrIR #embolization #trauma #endovasculartherapy #vascularintervention