Saturday, December 30, 2017

1st ultrasound and fluoroscopic sclerotherapy

on 12/30/2017 L underwent first sclerotherapy session.

Description [CATHLAB]

Local and general anesthesia was used.
Fluoroscopy and U/S guidance was used.
5 access sites using 21g and 22g needles. Micro-puncture sheeth placed in posterior tibial vein for saline flush and venograms. (fist site not used due to extravasation*).
Total of 10cc of 3% STS foam was used with good distribution on U/S.
Final venogram showed patent deep venous system.
No immediate complications.

Plan:
Do not apply any adhesive dressing on puncture sites.
VS and peripheral pulses Q30 min for 3 h.
Check site for bleeding, swelling and blistering with vitals for 3 h (elevate leg if excessive swelling)
Discharge in 3h when fully awake and stable.
F/U in clinic in 4 weeks.

Flouro time: - 2:06 sec
DAP: - .844 Gycm2
Total contrast: 10 ml
Blood loss: less then 3cc

Dictionary:

extravasation: is when a chemotherapy medication or other drug leaks outside the vein onto or into the skin, causing a reaction. In chemotherapy, drugs are classified into two broad categories based on the effect they have on tissues when they extravasate—irritants and vesicants.

STS foam: sodium tetradecyl sulfate, a sclerosing (skler-OH-sing) agent. It works by increasing the formation of blood clots and scar tissue inside certain types of veins. This helps decrease dilation of enlarged veins.

venogram: x-ray of the veins, involves injecting contrast material into a vein to shows how blood flows through your veins. This allows a physician to determine the condition of your veins.

L underwent fist sclerotherapy session well. We had 2 more to undergo.


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