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Additional lumens allow the addition of a guidewire and injection of radio-opaque contrast. They can be broadly categorized as pull-type, push-type, or needle-knife. [1] Pull-type: pull-type sphincterotomes consist of a steel cutting wire within a Teflon catheter. The wire exits the catheter approximately 3 cm before its distal end and re ...
A round-tipped guidewire is then advanced through the lumen of the needle, and the needle is withdrawn. A sheath or blunt cannula can now be passed over the guidewire into the cavity or vessel. Alternatively, drainage tubes are passed over the guidewire (as in chest drains or nephrostomies). After passing a sheath or tube, the guidewire is ...
Once the catheter is in the hepatic vein, a wedge pressure is obtained to calculate the pressure gradient in the liver. Following this, carbon dioxide is injected to locate the portal vein. Then, a special needle known as a Colapinto is advanced through the liver parenchyma to connect the hepatic vein to the large portal vein , near the center ...
The drainage catheter is then removed over the guidewire and sheath is inserted into the ducts (7 to 8 French size). Contrast is then injected through the sheath to identify any stones or strictures. If a stricture is identified, put in biliary manipulation catheter with guidewire measuring 0.035 inches and commence balloon dilatation (with ...
Once the catheter is in the extraluminal space, a guidewire is advanced in a loop configuration which allows for a more rigid structure that can be used to traverse the subintimal dissection plane when compared to the free end of a straight guidewire.
Blood is aspirated from the catheter to confirm the position. Then, the free-end of the port catheter is inserted through the peel-off sheath. After the tip of the port catheter is confirmed at the aortocaval junction, the peel-off sheath is taken-off by peeling away with two hands. While peeling off, the port catheter should remain in-situ.
Sinus surgery with balloons may be performed in a hospital, outpatient surgery setting or in the physician’s office under local anesthesia. The physician inserts a guide catheter through the nostril and near the sinus opening under endoscopic visualization. A flexible guide wire is then introduced into the targeted sinus to confirm access.
Used for example in steady advancement of the catheter on a guidewire previously inserted into the renal pelvis through a thin needle. D. Both obturator and puncture needle retracted, when the catheter is in the renal pelvis. E. Locking string is pulled (bottom center) and then wrapped and attach to the superficial end of the catheter.