Difference between revisions of "Superior vena cava recanalization"
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|Airway | |Airway | ||
| | | | ||
* | * Assess extent of airway edema | ||
* Evaluate imaging for the presence of an anterior mediastinal mass | * 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 | ||
| Line 35: | Line 36: | ||
|- | |- | ||
|Pulmonary | |Pulmonary | ||
| | | | ||
|- | |- | ||
|Hematologic | |Hematologic | ||
| | |Patients may be hypercoagulable | ||
|- | |- | ||
|Other | |Other | ||
| Line 53: | Line 45: | ||
|} | |} | ||
===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. -->=== | ||
==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. -->=== | ||
Revision as of 10:38, 10 August 2022
Superior vena cava recanalization
| Anesthesia type |
General |
|---|---|
| Airway |
ETT |
| Lines and access | |
| Monitors |
Standard ASA Art line |
| Primary anesthetic considerations | |
| Preoperative |
Airway edema Potential mediastinal mass |
| Intraoperative |
Major vessel injury Pulmonary embolus |
| Postoperative | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
A superior vena cava recanalization is an interventional radiology procedure performed to treat superior vena cava syndrome.
Overview
Indications
Surgical procedure
The procedure is typically performed via sheath access through a femoral vein.
Preoperative management
Patient evaluation
| System | Considerations |
|---|---|
| Airway |
|
| Neurologic | Neuro exam to evaluate for deficits if cerebral perfusion pressure decreased |
| Cardiovascular | |
| Pulmonary | |
| Hematologic | Patients may be hypercoagulable |
| Other |
Labs and studies
- 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
Patient preparation and premedication
Intraoperative management
Monitoring and 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
- Thorough airway evaluation is critical
- Significant airway edema is common
- Review chest imaging for the presence of an anterior mediastinal mass
Positioning
Maintenance and surgical considerations
Emergence
Postoperative management
Disposition
Pain management
Potential complications
Procedure variants
| Variant 1 | Variant 2 | |
|---|---|---|
| Unique considerations | ||
| Position | ||
| Surgical time | ||
| EBL | ||
| Postoperative disposition | ||
| Pain management | ||
| Potential complications |
References
Top contributors: Chris Rishel