Nathan Fein

26 statements · 1 topic

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▶ Ep 3 · 2:11
The basic technique for sharp SVC recanalization uses ultrasound to look at the jugular vein and then some combination of fluoro and ultrasound to guide a really tiny needle through the area of stenosis and through the SVC beyond the stenosis and into the right atrium.
clinical · Subclavian Thrombus
▶ Ep 2 · 2:11
Sharp SVC recanalization uses ultrasound to visualize the jugular vein and a combination of fluoroscopy and ultrasound to guide a small needle through the area of stenosis, through the SVC beyond the stenosis, and into the right atrium.
clinical · Subclavian Thrombus

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Nathan's statements about Subclavian Thrombus 26 statements

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Update Course Rewind 2025: Updates in Central Line Management

▶ Ep 2 · 0:23
clinical The patient was a teenager with a left subclavian dual lumen port and a history of subclavian thrombus that was successfully treated with heparin. ↗
▶ Ep 2 · 0:31
clinical The medial lumen of the port would not flush, while the lateral lumen functioned normally. ↗
▶ Ep 2 · 0:59
clinical Fluoroscopic dye study showed contrast welling up around the port and in the pocket itself, not going to the reservoir, when pushing very hard. ↗
▶ Ep 2 · 1:10
clinical The port malfunction was due to improper accessing; re-accessing the port resolved the issue and it flushed normally. ↗
▶ Ep 2 · 1:14
quote Just wasn't accessed right. All I did was I re-accessed it and it worked and it flushed. ↗
▶ Ep 2 · 1:22
clinical The hematology oncology team wanted the port removed immediately and had scheduled the patient for removal and replacement. ↗
▶ Ep 2 · 1:37
clinical Ultrasound suggested possible narrowing around the port catheter itself. ↗
▶ Ep 2 · 1:40
opinion If you pull the port catheter out in the setting of vessel narrowing, you have not lost any potential access for interventional radiology to work to maintain it. ↗
▶ Ep 2 · 1:54
quote The patients who have no upper and lower central access, no normal access. ↗
▶ Ep 2 · 1:54
clinical Vasculopaths are patients who have no upper and lower central access, no normal access. ↗
▶ Ep 2 · 2:06
clinical Interventional radiology can perform sharp recanalization of the SVC for vasculopaths. ↗
▶ Ep 2 · 2:11
clinical Sharp SVC recanalization uses ultrasound to visualize the jugular vein and a combination of fluoroscopy and ultrasound to guide a small needle through the area of stenosis, through the SVC beyond the stenosis, and into the right atrium. ↗
▶ Ep 2 · 2:29
clinical In sharp SVC recanalization, the interventionist can approach from below via the femoral vein to drive a needle through a target to connect the two sides, then perform balloon angioplasty, stent placement, and line placement. ↗

Central line troubleshooting and vascular access preservation in pediatric patients

▶ Ep 3 · 0:23
clinical The patient was a teenager with a left subclavian dual lumen port and a history of subclavian thrombus that was successfully treated with heparin. ↗
▶ Ep 3 · 0:59
quote I was pushing very hard to get contrast through, and there's just a little bit of contrast welling up around the port and in the pocket itself and not actually going to the reservoir. ↗
▶ Ep 3 · 0:59
clinical When pushing contrast very hard, there was just a little bit of contrast welling up around the port and in the pocket itself and not actually going to the reservoir. ↗
▶ Ep 3 · 1:14
quote Just wasn't accessed right. All I did was I re-accessed it and it worked and it flushed. ↗
▶ Ep 3 · 1:16
clinical Re-accessing the port made it work and flush properly. ↗
▶ Ep 3 · 1:22
clinical The hematology oncology team wanted the port removed and had set the patient up for a removal and replacement procedure. ↗
▶ Ep 3 · 1:37
clinical An ultrasound suggested there might be some narrowing around the port catheter itself. ↗
▶ Ep 3 · 1:40
clinical If you just pull the port catheter out when there is narrowing, you have not lost any potential access for interventional radiology to work together to maintain it. ↗
▶ Ep 3 · 1:54
quote The patients who have no upper and lower central access, no normal access. ↗
▶ Ep 3 · 1:54
clinical Vasculopaths are patients who have no upper and lower central access, no normal access. ↗
▶ Ep 3 · 2:06
clinical Interventional radiology can perform sharp recanalization of the SVC to restore access for vasculopaths. ↗
▶ Ep 3 · 2:11
clinical The basic technique for sharp SVC recanalization uses ultrasound to look at the jugular vein and then some combination of fluoro and ultrasound to guide a really tiny needle through the area of stenosis and through the SVC beyond the stenosis and into the right atrium. ↗
▶ Ep 3 · 2:32
clinical The interventionist can come from below from the femoral vein to drive a needle through a target to connect the two, perform balloon plasty and stent, and then place the line. ↗