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Drainage catheters and biopsy needles. John Hancock IR-TB April 2007. RCR IR curriculum. ‘Biopsy and fluid drainage techniques are practised by all radiologists and are not included in this curriculum’. Patient prep. Consent Anaesthesia/sedation Image guidance Techniques Aftercare. - PowerPoint PPT Presentation
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Drainage catheters and biopsy needles
John Hancock
IR-TB April 2007
RCR IR curriculum
• ‘Biopsy and fluid drainage techniques are practised by all radiologists and are not included in this curriculum’
• Patient prep.
• Consent
• Anaesthesia/sedation
• Image guidance
• Techniques
• Aftercare
Drains
Drains
• Will aspiration do?
• Type
• Size
• Approach/position
• Guidance
• Fixation
Type
• Pigtail or pigtail?
• Locking or non-locking?
• Sump?
• Number?
Size?
• Thin fluid 6 – 8 Fr
• Thin pus 8 – 10 Fr
• Thick pus 10 – 12 Fr
• Up to 20Fr+
Technique
• Needle, then…
• One step, one stick, or
• Two step over guidewire
Biopsy
• Needle type
• Image guidance
• Techniques– Coaxial– Transjugular– Plugged
Gauge
• Based on the Stubs Iron Wire Gauge measurement
• Inversely proportional and non-linear (thanks)
Aspiration cytology
• Fine needle
• 21 or 22g Chiba
• Safe
• Limited application – cells not tissue
Cutting needles
• Many types• 14g to 18g• Length of throw (variable)• Core of tissue• Manual• Automated/‘programmable’• Side notch• End cut
Familiarise yourself
Familiarise yourself
• This is my biopsy gun
• There are many like it but this one is mine
• My gun is my best friend
• I must master it as I must master my life
• My gun without me is useless
• Without my gun I am useless
• I must aim my gun true
Specimens
• Size (renal and lymphoma)
• Don’t forget microbiology
• They’re your responsibility