Superior vena cava recanalization - Revision history

Chris.Rishel at 17:50, 10 August 2022

2022-08-10T17:50:11Z

← Older revision		Revision as of 10:50, 10 August 2022
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	==Overview==		==Overview==
	===Indications===		===Indications===
			Superior vena cava recanalization is performed to restore normal venous drainage of the SVC and relieve symptoms of SVC syndrome.
	===Surgical procedure===		===Surgical procedure===
	The procedure is typically performed via sheath access through a femoral vein.		The procedure is typically performed via sheath access through a femoral vein.
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	* CBC		* CBC
	* Coagulation panel		* Coagulation panel
			* Consider CT chest to evaluate for anterior mediastinal mass
	* Consider TTE if concern for intracardiac thrombus		* Consider TTE if concern for intracardiac thrombus
	* Consider upper/lower extremity ultrasound with doppler if concern for DVT		* Consider upper/lower extremity ultrasound with doppler if concern for DVT
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	*Review chest imaging for the presence of an anterior mediastinal mass		*Review chest imaging for the presence of an anterior mediastinal mass
	===Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. -->===		===Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. -->===
			*Supine
	===Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. -->===		===Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. -->===

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	==Postoperative management==		==Postoperative management==
	===Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. -->===		===Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. -->===
			*Patients are typically positioned with the head of the bed at least 30° to facilitate venous drainage
	===Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. -->===		===Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. -->===
			*Minimal postoperative pain is expected
	===Potential complications<!-- List and/or describe any potential postoperative complications for this case. -->===		===Potential complications<!-- List and/or describe any potential postoperative complications for this case. -->===

Chris.Rishel at 17:38, 10 August 2022

2022-08-10T17:38:00Z

← Older revision		Revision as of 10:38, 10 August 2022
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	\|Airway		\|Airway
	\|		\|
	* ~~SVC syndrome may be associated with significant~~ airway edema		* Assess extent of airway edema
	* Evaluate imaging for the presence of an anterior mediastinal mass ~~which could necessitate awake fiberoptic intubation and/or a wire reinforced ETT.~~		* Evaluate tolerance for lying flat
			* Review imaging for the presence of an anterior mediastinal mass
	\|-		\|-
	\|Neurologic		\|Neurologic
	\|		\|Neuro exam to evaluate for deficits if cerebral perfusion pressure decreased
	\|-		\|-
	\|Cardiovascular		\|Cardiovascular
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	\|-		\|-
	\|Pulmonary		\|Pulmonary
	\|
	\|-
	~~\|Gastrointestinal~~
	\|		\|
	\|-		\|-
	\|Hematologic		\|Hematologic
	\|		\|Patients may be hypercoagulable
	\|-
	~~\|Renal~~
	\|
	\|-
	~~\|Endocrine~~
	\|
	\|-		\|-
	\|Other		\|Other
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	\|}		\|}
	===Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. -->===		===Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. -->===
			* CMP
			* CBC
			* Coagulation panel
			* Consider TTE if concern for intracardiac thrombus
			* Consider upper/lower extremity ultrasound with doppler if concern for DVT
	===Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. -->===		===Operating room setup<!-- Describe any unique aspects of operating room preparation. Avoid excessively granular information. Use drug classes instead of specific drugs when appropriate. If none, this section may be removed. -->===
	===Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. -->===		===Patient preparation and premedication<!-- Describe any unique considerations for patient preparation and premedication. If none, this section may be removed. -->===
	~~===Regional and neuraxial techniques<!-- Describe any potential regional and/or neuraxial techniques which may be used for this case. If none, this section may be removed. -->===~~

	==Intraoperative management==		==Intraoperative management==
	===Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. -->===		===Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. -->===
			* Large vessel clots may make reliable peripheral IV access challenging
			** Consider ephedrine test dose to determine circulation time
			** May require central access in vessel with no thrombus
	===Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. -->===		===Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. -->===
			*Thorough airway evaluation is '''critical'''
			*Significant airway edema is common
			*Review chest imaging for the presence of an anterior mediastinal mass
	===Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. -->===		===Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. -->===

Chris.Rishel: Added categories

2022-08-10T04:00:19Z

Added categories

← Older revision		Revision as of 21:00, 9 August 2022
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	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]
			[[Category:Interventional radiology]]

Chris.Rishel at 03:50, 10 August 2022

2022-08-10T03:50:01Z

← Older revision		Revision as of 20:50, 9 August 2022
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	\|Airway		\|Airway
	\|		\|
			* SVC syndrome may be associated with significant airway edema
			* Evaluate imaging for the presence of an anterior mediastinal mass which could necessitate awake fiberoptic intubation and/or a wire reinforced ETT.
	\|-		\|-
	\|Neurologic		\|Neurologic

Chris.Rishel: Started article

2022-08-10T03:46:27Z

Started article

New page

{{Infobox surgical procedure
| anesthesia_type = General
| airway = ETT
| lines_access =
| monitors = Standard ASA
Art line
| considerations_preoperative = Airway edema
Potential mediastinal mass
| considerations_intraoperative = Major vessel injury
Pulmonary embolus
| considerations_postoperative =
}}A '''superior vena cava recanalization''' is an interventional radiology procedure performed to treat [[Superior vena cava syndrome|superior vena cava syndrome]].

==Overview==
===Indications===
===Surgical procedure===
The procedure is typically performed via sheath access through a femoral vein.
==Preoperative management==
===Patient evaluation===
{| class="wikitable"
|+
!System
!Considerations
|-
|Airway
|
|-
|Neurologic
|
|-
|Cardiovascular
|
|-
|Pulmonary
|
|-
|Gastrointestinal
|
|-
|Hematologic
|
|-
|Renal
|
|-
|Endocrine
|
|-
|Other
|
|}
===Labs and studies===
===Operating room setup===
===Patient preparation and premedication===
===Regional and neuraxial techniques===

==Intraoperative management==
===Monitoring and access===

===Induction and airway management===

===Positioning===

===Maintenance and surgical considerations===

===Emergence===

==Postoperative management==
===Disposition===

===Pain management===

===Potential complications===

==Procedure variants==

{| class="wikitable wikitable-horizontal-scroll"
|+
!
!Variant 1
!Variant 2
|-
|Unique considerations
|
|
|-
|Position
|
|
|-
|Surgical time
|
|
|-
|EBL
|
|
|-
|Postoperative disposition
|
|
|-
|Pain management
|
|
|-
|Potential complications
|
|
|}

==References==

[[Category:Surgical procedures]]