Interventional and Endovascular Tips and Tricks of the Trade

S. Lowell Kahn, MD, MBA, FSIR is the Medical Director of the New England Endovascular Center and an Assistant Professor of Surgery and Interventional Radiology at Tufts University School of Medicine in Boston, MassachusettsBulent Arslan, MD is an Associate Professor of Radiology and the Director of Vascular & Interventional Radiology at Rush University Medical Center in Chicago, Illinois.Abdulrahman Masrani, MD is a Radiology Resident at the Mallinckrodt Institute of Radiology at Washington University in St. Louis, Missouri.

• I. Aortic Interventions1. Deployment Finesse of the Cook Zenith Stent Graft2. Deployment Finesse of the Gore Excluder Stent Graft3. The Turret Technique for Contralateral Gate Access4. Up and Over Snare Technique for the Difficult Contralateral Gate Access5. Use of a Buddy-Wire to Facilitate Contralateral Gate Catheterization During Endovascular Aortic Aneurysm Repair6. Tips for Accurate Palmaz Stent Deployment7. Managing Unilateral or Bilateral Common Iliac Artery Aneurysms with Preservation of the Hypogastric Artery8. In-vivo Fenestration During EVAR.9. Reverse Deployment of the Gore Excluder Contralateral Iliac Limbs for Aortoiliac Interventions10. Use of Two Bifurcated Stent-Grafts for Creation of an Aorto-Uni-Iliac (AUI) Endograft11. Creation of a Flow Modulating Stent Using Multi-layered Wallstents for Aneurysm Exclusion12. Obtaining True Lumen Access in Aortic Dissections with Iliac Extension13. The Endoconduit for Small Iliac Access 14. Transcaval Aortic Catheterization for TAVR and TEVAR Device Delivery II. Peripheral Vascular Interventions15. Subintimal Arterial Recanalization Using the Bull's Eye Technique16. Alternative Subintimal Entry and True Lumen Re-Entry Techniques17. Balloon Occlusion of Subintimal Tract to Assist Distal Luminal Re-entry During Subintimal Recanalization of Chronic Total Occlusions18. Extravascular Recanalization of Chronic Total Occlusions19. Retrograde Femoral Access for Difficult Superficial Femoral Artery Occlusions20. The 'Poor Man's' Sculpting Balloon21. Balloon Assisted Thrombin Injection for Pseudoaneurysms with Wide or Short Neck Morphology22. Intra-Procedural Management of Distal Embolization23. Techniques for Traversing Difficult Aortic Bifurcations and Aorto-Bifemoral Grafts 24. Flip Technique: Use of a Reverse Curve Catheter to Allow for Antegrade and Retrograde Femoral Access Through Single Access Site25. Technical Pearls for Managing the Scarred Groin III. Visceral, Renal, Pelvic, and Great Vessel Interventions26. Use of a Fogarty Occlusion Balloon During Splenic Artery Embolization to Prevent Distal Coil Migration27. Combined Endovascular and Surgical Retrograde SMA Recanalization28. Techniques for Treating Visceral Aneursyms and High-Flow AVMs of the Renal and Visceral Vasculature29. Proximal Arterial Occlusion during Treatment of Pelvic High Flow Arteriovenous Malformations IV. Venous and Pulmonary Arterial Interventions30. Reverse Deployment of the Gore Excluder Contralateral Iliac Limbs for Central Venous Occlusive Disease31. Branched Stent Graft Placement in the Vena Cava Using the Endologix AFX32. Needle Recanalization of Chronic Venous Total Occlusions33. Recanalization of Chronic Central Occlusions: Techniques to Cross Difficult Venous Occlusions 34. Managing Chronic Iliac Venous Occlusions That Extend Below the Inguinal Ligament35. Managing Iliocaval Acute Thrombosis36. Managing Iliocaval Chronic Thrombosis37. Directional AngioJet Thrombectomy with Guide Catheter Helical Spin Technique38. Dual and Balloon Assisted Angiojet Thrombectomy39. Tips and Tricks of the Angiovac Device40. Optimal Techniques for Catheterizing the Pulmonary Arteries without Dedicated Pulmonary Catheters V. Venous Access and Dialysis Interventions41. Minimally Invasive Repair of the Azygos Catheter Migration42. Endovascular Snaring Technique for Shortening of Central Venous Port Catheters in Children 43. Placing a Jugular Port without Direct Percutaneous Jugular Vein Access44. Transhepatic Snare Placement for Translumbar Inferior Vena Cava Access45. Fibrin Sheath Removal Techniques46. Obtaining Hemostasis at Your Puncture Sites47. Elimination of Post-Procedural Bleeding After Placement of Tunneled Dialysis Catheters48. Balloon Assisted Removal of the Trapped Catheter49. The Rapid Fistula Declot 50. Endovascular Options for Non-Maturing Fistulas due to Collateral Flow51. Percutaneous Creation of Jump Bypass in a Native Arteriovenous Hemodialysis Fistula52. Using a Glidewire Cheater and Flow Switch to Temporarily Secure Purse-string Sutures VI. Filter Placement and Retrieval53. Deploying a Straight Conical Filter54. Removing the angled inferior vena cava filter with an embedded hook - the 'Hangman' technique55. Femoral Flip Technique for Removal of the G2 Filter56. Femoral Retrieval of Conical Filters 57. Laser Sheath Assisted Filter Removal VII. Miscellaneous Catheterization, Wire, and Embolization Techniques58. Transradial Access Interventions59. Slow and Steady Method for Advancing Devices Through Tight or Tortuous Anatomy60. End of the Road: Bailout Techniques for the Short Wire61. Balloon Anchor Techniques for Sheath, Guide Catheter, and Stent Advancement and to Facilitate Chronic Total Occlusion Traversal 62. Catheter Modification Techniques for Venous Sampling63. Techniques for Forming Large Reverse Curve Catheters64. Clearing the Clogged Microcatheter During Particle Embolization65. The Anchor and Scaffold Techniques for Precise Coil Embolization 66. Selective Retrograde Chyle Duct Embolization VIII. Interventional Oncology and Biopsies67. Water Seal Technique For Lung Biopsy68. Extreme Thoracic Biopsies69. Balloon Occlusion Technique During Y90 Radioembolization70. Suprahepatic Catheter Placement for Hydrodissection71. Percutaneous Thermal Ablation: Hydrodissection & Balloon Displacement to Protect Adjacent Non-Target 72. Taming Cryoablation for Lung Tumors73. Bland Lipiodol Assisted Thermal Ablation of Renal Cell Carcinoma IX. Hepatobiliary Interventions74. Optimal Imaging Techniques of the Portal Vasculature During TIPS75. Use of Prolapsing Guidewire to Secure Portal Venous Access during TIPS76. Advancing the TIPS Sheath Through a Difficult Cirrhotic Liver: Pay It Forward Off the Balloon 77. The Gun-Site and Percutaneous Portocaval Techniques for the Challenging Transjugular Intrahepatic Portosystemic Shunt78. Deployment of a TIPS from a Femoral Vein Access (Femoral DIPS)79. Transmesenteric Method of TIPS Placement Using Portal Access Via Mini-Laparotomy80. Recanalization of Occluded Transjugular Intrahepatic Portosystemic Shunt Using a Transhepatic Percutaneous Technique81. Adjustable Small Diameter TIPS82. Use of a Coda Balloon to Assist Left Renal Vein Sheath Delivery During BRTO83. Use of Contrast Fortified Surgilube for Biliary Drainage in the Setting of Active Leakage84. Percutaneous Placement of a Temporary Large-Bore Biliary Endoprosthesis85. Method of Increasing Luminal Scaffolding for Biliary Strictures86. Use of a Fogarty Balloon Catheter to Create Backwall Support and Facilitate Intrahepatic Bile Duct Access During Antegrade Stone Extraction87. Portal Vein Tract Embolization after Percutaneous Transhepatic Biliary Interventions88. Use of an Elongated Radiopaque Gelatin Sponge Plug for Tract Occlusion After Hepatic Interventions X. Gastroenterology and Genitourinary Interventions89. Air Technique to Determine Appropriate Posterior Calyx for Puncture90. Permanent Ureteral Occlusion91. Exchange of Retrograde Occluded Nephroureteral Catheter Through Ileal Conduits Without Losing Access92. Use of a Mushroom-Retained Gastrostomy Tube for Stenting Benign Esophageal Strictures93. Balloon-Assisted, Fluoroscopically-Guided Percutaneous Gastrostomy Tube PlacementXI. Drainage Procedures94. Maximizing Visualization of Your Needle during Ultrasound Procedures95. Method for Optimal Tract Anesthesia During Biopsies, Drainiage Catheter Placement, Nephrostomies and and Percutaneous Transhepatic Cholangiography96. Tract-O-Gram to Reduce the Risk of Non-Target Catheterization During Placement of Drainage Tube97. Advancing the Difficult Drainage Catheter98. Creation of a Steerable Coaxial Needle System for Indirect Line-of-Site CT Guided Procedures99. Drainage of the Multiloculated Collection100. Transurethral Retrograde Approach to Pelvic Abscess Drainage in Post-Cystectomy Patients101. Creation of an Additional Sidehole as a Method to Exchange Obstructed Percutaneous Drainage Catheters102. Use of a Peel-Away Sheath as a Method to Exchange a Clogged Drainage Tube XII. Imaging and Pharmacology Techniques103. Optimizing CO2 Peripheral Arteriography104. Local Administration of FFP and Platelets in the Critically Ill Patient105. Reducing Operator Exposure Using Suspended Radiation Protection System