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Drainage catheters and biopsy needles

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.

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Drainage catheters and biopsy needles

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  1. Drainage catheters and biopsy needles John Hancock IR-TB April 2007

  2. RCR IR curriculum • ‘Biopsy and fluid drainage techniques are practised by all radiologists and are not included in this curriculum’

  3. Patient prep. • Consent • Anaesthesia/sedation • Image guidance • Techniques • Aftercare

  4. Drains

  5. Drains • Will aspiration do? • Type • Size • Approach/position • Guidance • Fixation

  6. Type • Pigtail or pigtail? • Locking or non-locking? • Sump? • Number?

  7. Size? • Thin fluid 6 – 8 Fr • Thin pus 8 – 10 Fr • Thick pus 10 – 12 Fr • Up to 20Fr+

  8. Technique • Needle, then… • One step, one stick, or • Two step over guidewire

  9. Biopsy • Needle type • Image guidance • Techniques • Coaxial • Transjugular • Plugged

  10. Gauge • Based on the Stubs Iron Wire Gauge measurement • Inversely proportional and non-linear (thanks)

  11. Aspiration cytology • Fine needle • 21 or 22g Chiba • Safe • Limited application – cells not tissue

  12. Cutting needles • Many types • 14g to 18g • Length of throw (variable) • Core of tissue • Manual • Automated/‘programmable’ • Side notch • End cut

  13. Familiarise yourself

  14. 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

  15. Specimens • Size (renal and lymphoma) • Don’t forget microbiology • They’re your responsibility

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