MEDRADSC 3C03 Lecture Notes - Lecture 6: Formaldehyde, Comorbidity, Band-Aid
27 May 2018
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Interventional pause:
1. Who is behind the promotion of the interventional pause?
o WHO, there are errors that can be made in practice, interventional pause is to try and
prevent mistakes
2. When is it indicated to run clotting assessments? (patient information- not type of test)
o Based o the pt ifo you get…
o When is it going to be relevant
o Coagulating problem
o Disease process affecting clotting- liver disease and cancer (cancer- can demo clotting
issues before even diagnosed with cancer)
o If pt on heparin or warfarin
o Anytime you have a needle in deep structures with risk of bleeding out
o Very vascular structures or lesions
Percutaneous Biopsy Basics
Protocol
• Every interventional imaging area will have a protocol manual that will cover:
o patient preparation
o pre procedure blood work requirements
▪ clotting assessment
o contraindications to the procedure
o procedure set up
o image requirements
▪ to confirm the success or failure of procedure
o post procedure requirements
• This material is a very broad look at common procedures
Pre and Post Biopsy
• Pre biopsy
o Patient prep (?NPO, Fluid, contrast consent)
o Core biopsies, vascular organs- PTT (partial thromboplastin time), prothrombin time
(PT), platelet level
o Discontinuation of blood thinners for approximately 1 week
o Modality choice will also determine pre biopsy plan
▪ Rads tend to stick to procedures they are more familiar with (less of an issue
now)
• Post Biopsy
o Depends on: site of biopsy, pt coagulatory status
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o From Bandaid → cold compress → nurse observation → overnight stay with nurse
observation
▪ If comorbidities= overnight
o Complications: infection, bleeding, severe hemorrhage, death
Types of Biopsies
• Focal Core Biopsies:
o Small/localized area
o Mass of unknown origin
o Suspected metastatic disease- can be used for definitive diagnosis
• General core Biopsies:
o Looking at functional issues
o Infiltrative diseases
• Fine needle aspiration: less common
o Could use this to aspirate a yst fluid, ut he talkig aout iopsy of ells= fie
eedle iopsy
o Bleeding disorders
▪ Use FNA for clotting reasons
o Lymphoma
o Bowel/ lung traversed
▪ Dot at huge ore saple eause it has to go through the oel/lug,
leaving a huge hole→ infection, extravasation of fluids/matter to areas they
shouldt e goig to
Core Biopsies
• Modality is chosen based on:
o location of biopsy to be taken
▪ deep to bone, lung or bowel
o CT, otherwise ultrasound
o Comfort level of radiologist with modality
• Biopsy guns
Throw length: how far out the needle advances in order to acquire the sample
find more resources at oneclass.com
find more resources at oneclass.com
