Interventional and Endovascular Tips and Tricks of the Trade

Through 105 highly-illustrated chapters, Interventional and Endovascular Tips and Tricks of the Trade equips interventional radiologists, surgeons, and cardiologists with unique techniques for solving complex clinical problems that may arise during both vascular and non-vascular procedures. The techniques are presented as succinct steps with particular attention paid to applications, challenges, and potential pitfalls. The accessible outline format and illustrative case examples optimize learning, patient selection, and outcomes. Suggested further readings are included with each technique. The "outside-the-box" strategies presented in this volume are useful solutions to clinical challenges in the ever-evolving field of interventional medicine, with its innovative technology, devices, and procedures.

Table of Contents:
I. Aortic Interventions 1. Deployment Finesse of the Cook Zenith Stent Graft 2. Deployment Finesse of the Gore Excluder Stent Graft 3. The Turret Technique for Contralateral Gate Access 4. Up and Over Snare Technique for the Difficult Contralateral Gate Access 5. Use of a Buddy-Wire to Facilitate Contralateral Gate Catheterization During Endovascular Aortic Aneurysm Repair 6. Tips for Accurate Palmaz Stent Deployment 7. Managing Unilateral or Bilateral Common Iliac Artery Aneurysms with Preservation of the Hypogastric Artery 8. In-vivo Fenestration During EVAR. 9. Reverse Deployment of the Gore Excluder Contralateral Iliac Limbs for Aortoiliac Interventions 10. Use of Two Bifurcated Stent-Grafts for Creation of an Aorto-Uni-Iliac (AUI) Endograft 11. Creation of a Flow Modulating Stent Using Multi-layered Wallstents for Aneurysm Exclusion 12. Obtaining True Lumen Access in Aortic Dissections with Iliac Extension 13. The Endoconduit for Small Iliac Access 14. Transcaval Aortic Catheterization for TAVR and TEVAR Device Delivery II. Peripheral Vascular Interventions 15. Subintimal Arterial Recanalization Using the Bull's Eye Technique 16. Alternative Subintimal Entry and True Lumen Re-Entry Techniques 17. Balloon Occlusion of Subintimal Tract to Assist Distal Luminal Re-entry During Subintimal Recanalization of Chronic Total Occlusions 18. Extravascular Recanalization of Chronic Total Occlusions 19. Retrograde Femoral Access for Difficult Superficial Femoral Artery Occlusions 20. The 'Poor Man's' Sculpting Balloon 21. Balloon Assisted Thrombin Injection for Pseudoaneurysms with Wide or Short Neck Morphology 22. Intra-Procedural Management of Distal Embolization 23. Techniques for Traversing Difficult Aortic Bifurcations and Aorto-Bifemoral Grafts 24. Flip Technique: Use of a Reverse Curve Catheter to Allow for Antegrade and Retrograde Femoral Access Through Single Access Site 25. Technical Pearls for Managing the Scarred Groin III. Visceral, Renal, Pelvic, and Great Vessel Interventions 26. Use of a Fogarty Occlusion Balloon During Splenic Artery Embolization to Prevent Distal Coil Migration 27. Combined Endovascular and Surgical Retrograde SMA Recanalization 28. Techniques for Treating Visceral Aneursyms and High-Flow AVMs of the Renal and Visceral Vasculature 29. Proximal Arterial Occlusion during Treatment of Pelvic High Flow Arteriovenous Malformations IV. Venous and Pulmonary Arterial Interventions 30. Reverse Deployment of the Gore Excluder Contralateral Iliac Limbs for Central Venous Occlusive Disease 31. Branched Stent Graft Placement in the Vena Cava Using the Endologix AFX 32. Needle Recanalization of Chronic Venous Total Occlusions 33. Recanalization of Chronic Central Occlusions: Techniques to Cross Difficult Venous Occlusions 34. Managing Chronic Iliac Venous Occlusions That Extend Below the Inguinal Ligament 35. Managing Iliocaval Acute Thrombosis 36. Managing Iliocaval Chronic Thrombosis 37. Directional AngioJet Thrombectomy with Guide Catheter Helical Spin Technique 38. Dual and Balloon Assisted Angiojet Thrombectomy 39. Tips and Tricks of the Angiovac Device 40. Optimal Techniques for Catheterizing the Pulmonary Arteries without Dedicated Pulmonary Catheters V. Venous Access and Dialysis Interventions 41. Minimally Invasive Repair of the Azygos Catheter Migration 42. Endovascular Snaring Technique for Shortening of Central Venous Port Catheters in Children 43. Placing a Jugular Port without Direct Percutaneous Jugular Vein Access 44. Transhepatic Snare Placement for Translumbar Inferior Vena Cava Access 45. Fibrin Sheath Removal Techniques 46. Obtaining Hemostasis at Your Puncture Sites 47. Elimination of Post-Procedural Bleeding After Placement of Tunneled Dialysis Catheters 48. Balloon Assisted Removal of the Trapped Catheter 49. The Rapid Fistula Declot 50. Endovascular Options for Non-Maturing Fistulas due to Collateral Flow 51. Percutaneous Creation of Jump Bypass in a Native Arteriovenous Hemodialysis Fistula 52. Using a Glidewire Cheater and Flow Switch to Temporarily Secure Purse-string Sutures VI. Filter Placement and Retrieval 53. Deploying a Straight Conical Filter 54. Removing the angled inferior vena cava filter with an embedded hook - the 'Hangman' technique 55. Femoral Flip Technique for Removal of the G2 Filter 56. Femoral Retrieval of Conical Filters 57. Laser Sheath Assisted Filter Removal VII. Miscellaneous Catheterization, Wire, and Embolization Techniques 58. Transradial Access Interventions 59. Slow and Steady Method for Advancing Devices Through Tight or Tortuous Anatomy 60. End of the Road: Bailout Techniques for the Short Wire 61. Balloon Anchor Techniques for Sheath, Guide Catheter, and Stent Advancement and to Facilitate Chronic Total Occlusion Traversal 62. Catheter Modification Techniques for Venous Sampling 63. Techniques for Forming Large Reverse Curve Catheters 64. Clearing the Clogged Microcatheter During Particle Embolization 65. The Anchor and Scaffold Techniques for Precise Coil Embolization 66. Selective Retrograde Chyle Duct Embolization VIII. Interventional Oncology and Biopsies 67. Water Seal Technique For Lung Biopsy 68. Extreme Thoracic Biopsies 69. Balloon Occlusion Technique During Y90 Radioembolization 70. Suprahepatic Catheter Placement for Hydrodissection 71. Percutaneous Thermal Ablation: Hydrodissection & Balloon Displacement to Protect Adjacent Non-Target 72. Taming Cryoablation for Lung Tumors 73. Bland Lipiodol Assisted Thermal Ablation of Renal Cell Carcinoma IX. Hepatobiliary Interventions 74. Optimal Imaging Techniques of the Portal Vasculature During TIPS 75. Use of Prolapsing Guidewire to Secure Portal Venous Access during TIPS 76. Advancing the TIPS Sheath Through a Difficult Cirrhotic Liver: Pay It Forward Off the Balloon 77. The Gun-Site and Percutaneous Portocaval Techniques for the Challenging Transjugular Intrahepatic Portosystemic Shunt 78. Deployment of a TIPS from a Femoral Vein Access (Femoral DIPS) 79. Transmesenteric Method of TIPS Placement Using Portal Access Via Mini-Laparotomy 80. Recanalization of Occluded Transjugular Intrahepatic Portosystemic Shunt Using a Transhepatic Percutaneous Technique 81. Adjustable Small Diameter TIPS 82. Use of a Coda Balloon to Assist Left Renal Vein Sheath Delivery During BRTO 83. Use of Contrast Fortified Surgilube for Biliary Drainage in the Setting of Active Leakage 84. Percutaneous Placement of a Temporary Large-Bore Biliary Endoprosthesis 85. Method of Increasing Luminal Scaffolding for Biliary Strictures 86. Use of a Fogarty Balloon Catheter to Create Backwall Support and Facilitate Intrahepatic Bile Duct Access During Antegrade Stone Extraction 87. Portal Vein Tract Embolization after Percutaneous Transhepatic Biliary Interventions 88. Use of an Elongated Radiopaque Gelatin Sponge Plug for Tract Occlusion After Hepatic Interventions X. Gastroenterology and Genitourinary Interventions 89. Air Technique to Determine Appropriate Posterior Calyx for Puncture 90. Permanent Ureteral Occlusion 91. Exchange of Retrograde Occluded Nephroureteral Catheter Through Ileal Conduits Without Losing Access 92. Use of a Mushroom-Retained Gastrostomy Tube for Stenting Benign Esophageal Strictures 93. Balloon-Assisted, Fluoroscopically-Guided Percutaneous Gastrostomy Tube Placement XI. Drainage Procedures 94. Maximizing Visualization of Your Needle during Ultrasound Procedures 95. Method for Optimal Tract Anesthesia During Biopsies, Drainiage Catheter Placement, Nephrostomies and and Percutaneous Transhepatic Cholangiography 96. Tract-O-Gram to Reduce the Risk of Non-Target Catheterization During Placement of Drainage Tube 97. Advancing the Difficult Drainage Catheter 98. Creation of a Steerable Coaxial Needle System for Indirect Line-of-Site CT Guided Procedures 99. Drainage of the Multiloculated Collection 100. Transurethral Retrograde Approach to Pelvic Abscess Drainage in Post-Cystectomy Patients 101. Creation of an Additional Sidehole as a Method to Exchange Obstructed Percutaneous Drainage Catheters 102. Use of a Peel-Away Sheath as a Method to Exchange a Clogged Drainage Tube XII. Imaging and Pharmacology Techniques 103. Optimizing CO2 Peripheral Arteriography 104. Local Administration of FFP and Platelets in the Critically Ill Patient 105. Reducing Operator Exposure Using Suspended Radiation Protection System

About the Author :
S. Lowell Kahn, MD, MBA, FSIR is the Medical Director of the New England Endovascular Center and an Assistant Professor of Surgery and Interventional Radiology at Tufts University School of Medicine in Boston, Massachusetts Bulent Arslan, MD is an Associate Professor of Radiology and the Director of Vascular & Interventional Radiology at Rush University Medical Center in Chicago, Illinois. Abdulrahman Masrani, MD is a Radiology Resident at the Mallinckrodt Institute of Radiology, Washington University in St. Louis, Missouri.