Diagnostic Procedure Inventory Flashcards
Angiographic Catheter
Long, hollow tubes that provide a conduit for medications or for advancing therapeutic devices into an area of interest. Categorized by their shape, size, and function. Specialized for various parts of the body and specific purposes
Catheter Size
- Depends on pt. size as well as area of interest.
- 3F-5F used for peds.
- 4F-9F used for adults.
- 1.5F-3F reffered to as microcatheters
French
-Outside diameter of a catheter
-Named after 19th century Parisian Surgical Instrument designer Joseph-Frederic-Benoit Charriere
-1Fr. is equal to 1/3rd of a millmeter
-most commonly used for catheters, however many IR tools are measured in Fr.
Microcatheters
-Used by advancing through the inner cannula of larger angiographic catheters for support
-smaller and more flexible
-used to reach or superselect smaller 2nd and 3rd order vasculature
Catheter Shape
- Come pre-shaped in a variety of configurations
- Shape determines procedural application
- Straight, curved, shepherds hook, hockey stick, pig-tail
- Some catheters have multiple uses, others are highly specialized
Catheter Function
- Diagnostic angiographic catheters are mostly used for imaging the vascular system
- Interventional therapeutic catheters are used to treat vascular conditions found during angiography.
- Drainage Catheters
- Central Venous Access
- Delivering Nutrition
Diagnostic Catheters
- Main function is to deliver contrast to vessels of interest.
- Used as delivery mechanisms for therapeutic agents such as embolics, thrombolytics, and blood thinners.
- Used to advance balloons, stents, and other devices
Therapeutic Catheters
- Used to treat vessel stenosis, aneurysms, atherosclerotic disease, thrombi, and to remove foreign bodies from inside vasculature.
- Catheter-mounted Stents (expand stenotic lesions)
- Coil Cath. (embolize aneurysms)
- Snares
- Atherectomy
- Mechanical Thrombectomy
- Embolectomy
Drainage Catheters
- Designed to drain excess fluid from one area in the body to another OR to remove fluid from the body.
- Can be placed in the biliary system, thoracic cavity, peritoneal space, genitourinary system, abscess, etc.
- Range in size from 6F - 26F
- End holes and multiple side holes
Nutrition Delivery Catheters
- Usually referred to as “tubes”
- G-tube
- NG-tube
- Corpak
- Used for delivery of nutrition as well as for gastric decompression
- Length depends on which section of GI system the catheter will be positioned in.
Central Venous Access Catheters
Available in 4 types:
- PICC (Peripherally Inserted Central Catheter
- Temp. Lines or Temp. Caths (temporary, non-tunneled CVCs)
- Perm. Caths (Tunneled CVCs)
- Ports
Catheter Construction
Can be made of:
- Silicone, Rubber, Latex, Nylon, Teflon, Polyurethane, Polyethylene, polyvinylchloride, nitinol, etc.
- May be made to be hydrophillic in order to pass through vasculature easilly
- Some are radiopaque and some more radiolucent
- Memory: cath returns easilly to original shape
- Tractable: advance easilly over a guidewire
- Torque: ability to twist and turn in response to operator conrol
Guidewires
- Used in IR to secure an initial route into: vascular, GI, GU, or biliary systems.
- After access is obtained into desired system IR personnel advance a catheter over the wire to location of interest.
- Scrub Tech. is responsible for monitoring the wire
- Rear end of the wire should always protrude from the distal end of the catheter
- Should never fall below the level of the techs waist
- Vary in length from 60cm to up to 300cm
- wire must be longer than the catheter to ensure that its not lost during catheter placement. (extra 10cm in length is sufficient to ensure catheter isnt lost)
- Most common length is 180cm (about 6ft)
- Shorter guidewires used for upper extremity and visceral organ access
- Longer guidewires are used to exchange guiding systems during procedures
- FOR EXCHANGES: guidewire should be twice as long as the catheter to ensure the wire isnt lost during the transition from guiding system to microsystem
Guidewire Diameter
- Measured in fractions of an inch ranging from (0.014 - 0.045)
- Most common standard guidewire is 0.035
- Most common standard microwire is 0.018
Guidewire Construction
- Guidewires selected based on their shape. (straight, curved, angled, j-shaped, or coiled)
- Taper at proximal end is often more flexible than distal end
- Can be constructed of: platinum, stainless steel, stainless steel-nickel alloy, titanium, tungsten, nickel-titanium alloy(Nitinol), or gold)
- materials are radiopaque and easily scene under fluoroscope
- Inner core of straight wire wrapped with and additional strand of wire allowing the core to be fixed or to move.
- Stiffer wire provides better tractability and more stability to advance a catheter(ex. Digestive system is soft and pliable so a stiff wire is used to more easily advance tubes)
- Stiff guidewires are effective in crossing tight stenosis
