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Case 13: Tunnelled Dialysis Cath insertion done elsewhere. Referred for no backflow. What next? . #irad #MedTwitter #MedEd SIR RFS SIR ECS Society of Interventional Radiology Keith Pereira MD, #VIrad Keerthi Prasad Kumar Madassery Lorenzo Patrone Mark Lessne, MD Srini Tummala MD FSIR FSVM Venkat Tummala MD MBA

Комментарии: 10

Фото профиля Cole Bahakel, MD
Cole Bahakel, MD2 лет назад

@SIRRFS @SIR_ECS @SIRspecialists @keithppereira @KprasMD @kmadass @vascularIR @LessneVIR @SriniTummala @t_intheleadcoat @_backtable @IVISymposium @Vascular_India @iRadRock @TheRealDoctorOs @monteromiguel @IRadPatwary @iRadBIR_Chennai Never seen a trans-venous PTEG access before

Фото профиля Peter Bream
Peter Bream2 лет назад

@SIRRFS @SIR_ECS @SIRspecialists @keithppereira @KprasMD @kmadass @vascularIR @LessneVIR @SriniTummala @t_intheleadcoat @_backtable @IVISymposium @Vascular_India @iRadRock @TheRealDoctorOs @monteromiguel @IRadPatwary @iRadBIR_Chennai Classic dilation from left IJ perf through bottom of left brachiocephalic. Pull over a wire and drop some coils at the perf site. Find who did it and educate.

Фото профиля Pulkit Rangarh
Pulkit Rangarh2 лет назад

@SIRRFS @SIR_ECS @SIRspecialists @keithppereira @KprasMD @kmadass @vascularIR @LessneVIR @SriniTummala @t_intheleadcoat @_backtable @IVISymposium @Vascular_India @iRadRock @TheRealDoctorOs @monteromiguel @IRadPatwary @iRadBIR_Chennai extravascular space. It occurs when wire is pushed and it penetrates through posterior wall. Take similiar jugular access , negotiate into IVC, take balloon catheter and put it at same site where there must be rent at crossing point. Slight inflation , remove previous catheter.

Фото профиля Keerthi Prasad
Keerthi Prasad2 лет назад

@SIRRFS @SIR_ECS @SIRspecialists @keithppereira @kmadass @vascularIR @LessneVIR @SriniTummala @t_intheleadcoat @_backtable @IVISymposium @Vascular_India @iRadRock @TheRealDoctorOs @monteromiguel @IRadPatwary @iRadBIR_Chennai Agree mediastinal placement- prob inject to check on esophagus . Curious where it left the vein… Seen 1 case of esophageal perf from tunneling …

Фото профиля Lorenzo Patrone
Lorenzo Patrone2 лет назад

@SIRRFS @SIR_ECS @SIRspecialists @keithppereira @KprasMD @kmadass @LessneVIR @SriniTummala @t_intheleadcoat @_backtable @IVISymposium @Vascular_India @iRadRock @TheRealDoctorOs @monteromiguel @IRadPatwary @iRadBIR_Chennai Easy diagnosis even on the xray.. catheter in the azygos.. remove and reposition. Is the SVC thrombus chronic? To try to aspirate/remove it should be considered to avoid SVC obstruction in the future...

Фото профиля Karan Anandpara
Karan Anandpara2 лет назад

@SIRRFS @SIR_ECS @SIRspecialists @keithppereira @KprasMD @kmadass @LessneVIR @SriniTummala @t_intheleadcoat @_backtable @IVISymposium @Vascular_India @iRadRock @TheRealDoctorOs @monteromiguel @IRadPatwary @iRadBIR_Chennai Felt it’s actually in the mediastinum. Not in a vein or collateral. As per the CT

Фото профиля radiollama
radiollama2 лет назад

@SIRRFS @SIR_ECS @SIRspecialists @keithppereira @KprasMD @kmadass @vascularIR @LessneVIR @SriniTummala @t_intheleadcoat @_backtable @IVISymposium @Vascular_India @iRadRock @TheRealDoctorOs @monteromiguel @IRadPatwary @iRadBIR_Chennai The final distal ct images are concerning for possible esophagus. Which is just plain weird.

Фото профиля Karan Anandpara
Karan Anandpara2 лет назад

@SIRRFS @SIR_ECS @SIRspecialists @keithppereira @KprasMD @kmadass @vascularIR @LessneVIR @SriniTummala @t_intheleadcoat @_backtable @IVISymposium @Vascular_India @iRadRock @TheRealDoctorOs @monteromiguel @IRadPatwary @iRadBIR_Chennai Yes. Looks like it’s in the paraesophageal soft tissue. In the mediastinum. Probably due to rough wire manipulation

Фото профиля James J. Wynn
James J. Wynn2 лет назад

@SIRRFS @SIR_ECS @SIRspecialists @keithppereira @KprasMD @kmadass @vascularIR @LessneVIR @SriniTummala @t_intheleadcoat @_backtable @IVISymposium @Vascular_India @iRadRock @TheRealDoctorOs @monteromiguel @IRadPatwary @iRadBIR_Chennai Obviously need to determine if esophageal perf is real. Water-soluble contrast study either fluoro or CT. If no leak, pull the catheter. If the esophagus is perforated, get your friendly esophageal surgeon involved to discuss mgmt.

Фото профиля Cassra N. Arbabi MD
Cassra N. Arbabi MD2 лет назад

@SIRRFS @SIR_ECS @SIRspecialists @keithppereira @KprasMD @kmadass @vascularIR @LessneVIR @SriniTummala @t_intheleadcoat @_backtable @IVISymposium @Vascular_India @iRadRock @TheRealDoctorOs @monteromiguel @IRadPatwary @iRadBIR_Chennai Does look a lot like it’s in the esophagus but that would be close to impossible to achieve, but hey who knows? Endoscopy and if no esophageal perf then just pull.

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