Tunneled Paracentesis Catheter

Patients with a variety of abdominal malignancies may develop intractable ascites in the final stages of their illness. These patients suffer from abdominal pain, shortness of breath, nausea, and are often unable to engage in the routine activities of daily living. Therapeutic paracentesis is a low risk procedure, but it must be performed repeatedly to provide relief from distention and discomfort. Weekly trips to the hospital for repeated paracentesis can become difficult and disruptive. Tunneled catheters have long been used for peritoneal dialysis, and their percutaneous placement is well-described. A logical extension of this technique was to use these catheters for intractable malignant ascites. The procedure is associated with a very low complication or infection rate. The catheter is placed by the interventionalist using ultrasound and fluoroscopic guidance, generally in an outpatient setting. The device allows the patient to drain their own ascites at home or in a hospice setting, providing symptomatic relief without necessitating frequent trips to the hospital.

Portal vein embolization

Preoperative portal vein embolization is a procedure performed by the interventional radiologist in selected patients undergoing major liver resection. Portal vein embolization redirects portal venous blood flow into the non-resected portion of the liver, or future liver remnant. This initiates hypertrophy, or growth, of the non treated segment, increasing the patient’s functional liver reserve prior to surgery. Portal vein embolization can allow for safe, potentially curative partial liver resection in selected patients who otherwise may not have been eligible for resection based on an anticipated small remnant liver.

Intravascular foreign body retrieval

Intravascular foreign body retrieval is a procedure whereby the interventional radiologist uses specialized catheters and snares to retrieve foreign bodies within a blood vessel using fluoroscopic guidance. Frequently this involves retrieving a fragment of a broken intravascular catheter or other implantable medical device.