Superior Vena Cava (SVC) and Central Vein procedures – Angioplasty, Stenting

PREOP EVALUATION

• Clinic Visit if outpatient
• Need to review any imaging studies during clinic visit – if outside studies, have patient bring disc

TIMING / BED REST AFTER PROCEDURE

• 1 hour

ANTICOAGULATION/ANTIPLATELETS

• Aspirin or Plavix – Continue taking these medications.
• Lovenox, Low Molecular Weight Heparin (LMWH), Arixtra – Stop 24h prior to procedure
• Pradaxa – stop 3 days prior to procedure if possible.  See “Warfarin” immediately below for “bridge” anticoagulation, if necessary (CONTACT IR physician if uncertain)
• Warfarin (Coumadin) – Depends upon procedure and indication, as well as the reason the patient is taking this medication (CONTACT IR physician or PA)

LOCATION OF THE PROCEDURE

• Cath lab

PREOPERATIVE ORDERS

• IV with NS (Normal Saline) 75ml/hr
• CBC, PT/INR, PTT, Chem Basic, fibrinogen
• If extremity is swollen, have nurse measure diameter of extremity at largest point and contralateral extremity at same site
• Take picture before procedure

FOLLOW UP

• Call 1-2 days after discharge
• Clinic visit at 1-2 weeks, 3 months after procedure
• Check with IR physician regarding follow up imaging

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