Fig. 13.1
Hemostasis after transhepatic catheterization: (a) A small volume (1–2 ml) of the contrast is injected to visualize the hepatic veins. (b) An MReye Embolization Coil (0.035 in. × 4 cm × 3 mm) is advanced to the end of the sheath and deployed between the hepatic vein and the liver capsule. (c) The intraparenchymal position of the sheath tip is documented by contrast injection
After catheterization, patients are monitored, their vital signs are checked, and the percutaneous transhepatic puncture site is inspected every 15 min for 1 h, every 30 min for 2 h, and then every 2 h until hospital discharge on the following day [3].
13.1.3.4 Surgical Vascular Access
When the Seldinger method fails or when larger introducer sheaths are used, a surgical access may be preferred. Sheaths are inserted through the artery or vein and secured with two purse-string sutures using Prolene 6/0. After sheath’s removal, the ends of the suture are drawn tight and the wound is closed like a purse. Once the hemostasis is achieved, the subcutaneous tissues are closed with Vicryl 4/0 and the skin is sutured with Dermalon 4/0 (skin sutures are removed after 2 weeks).
< div class='tao-gold-member'>
Only gold members can continue reading. Log In or Register to continue
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
