PREOP:
- Check CBC, coags, LFTs
- No heparin
- Pre-medications: Unasyn 3g IV (levaquin + flagyl if allergic to pen), zofran 4mg, benadryl 50mg
ESTIMATED TIME: 35MIN
Equipment Always Necessary:
- 19G needle
- J-wire
- 6Fr Sheath
- 6Fr Pigtail
- Diagnostic cahteter - C2
- Wire: Glidewire
- Microcatheter - Progreat 2.8Fr
- 0.018 Glidewire GT 45 degrees
PREP:
- POSITION: Supine. Arms on arm-board or above the head since we will perform dyna CT (spin)
- Make sure the Leonardo is turned on !!!
- DRAPE: standard groin prep
- LOAD THE INJECTOR - 100cc
- Scout image
- Separate Mayo Stand for embolizations equipmen
- Protection equipment (gloves, gown, eyeware (see pic)
Injection Rates
- Aortogram: 20 / 20
- SMA 4 / 28
- Celiac 4/12
- Common hepatic (dyna) 4/28
Stand by Equipment
- Sos-omni - catheter
- Different catheters (sim 1, sim 2)
Equipment in Mayo Stand:
- Need sterile green towels (ortho bumps)
- LC beds soaked in chemo
- 2 x three-way stop cocks
- 1cc medallion syringes (3ea)
- 3cc medallion syringes (3ea)
- Blue - Saline
- Red - Contrast
- Yellow or white -
Dressing:
- No dressing !!! Just derma bond
PEARLS:
- For HCC and most tumors, the chemo agent is doxorrubicin. For some tumors irinotecan may work better.
