Nathan Fagan

23 statements · 1 topic

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It's going to work the best when there is at least a remnant of something there that you can get through, but if there is something, this might be safer than me trying to jab a needle down there and get into the right atrium.
quote · Thrombosis
Transhepatic access makes the most sense because if there's bleeding or if it gets dislodged, particularly in pediatric patients, I Like it's easier to get to or control.
quote · Thrombosis

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Nathan's statements about Thrombosis 23 statements

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Update Course Rewind 2025: New Technologies for Central Line Management

Statement The Surfacer is made by Merritt Medical and is image guided SVC recannulation using a special piece of equipment. Open
Quotation It's basically image guided SVC recannulation using a special piece of equipment. Open
Statement The Surfacer works best when there is at least a remnant of something there that you can get through. Open
Statement The Surfacer might be safer than trying to jab a needle down to the right atrium when there is a remnant lumen. Open
Quotation It's going to work the best when there is at least a remnant of something there that you can get through, but if there is something, this might be safer than me trying to jab a needle down there and get into the right atrium. Open
Statement The Surfacer technique involves burying a special catheter where you want your exit site to be and creating a target at 90 degrees where the catheter will exit. Open
Quotation We can essentially draw a target 90 degrees is where we think we're going to come out of. Open
Statement The operator drives a special needle through the catheter that has been pulled up to the skin surface. Open
Statement 4D intracardiac echo catheter is used more in cardiology for ablations or left atrial appendage occlusions. Open
Statement The 4D intracardiac echo probe projects an ultrasound wave in 360 degrees. Open
Quotation Basically projects an ultrasound wave in 360 degrees. Open
Statement The 4D echo image can be reconstructed in any plane to guide the needle across an occlusion. Open
Quotation So then you can reconstruct that image in any way, any plane you want, whether it be anterior, posterior, inferior, bottom, right. Open
Statement The technique involves getting access from above with a normal ultrasound, then using the special 4D catheter to reconstruct and guide the needle across the occlusion. Open
Quotation So nobody's doing this yet. Open
Statement Nobody is using 4D intracardiac echo for central line recanalization yet. Open
Quotation We're using these more for tips, but the premise is still the same. Open
Statement 4D intracardiac echo catheters are being used more for TIPS procedures. Open
Statement There is a big debate on whether to use transhepatic or translumbar access. Open
Quotation There's a big debate on which one to do. Open
Statement Transhepatic access makes the most sense in pediatric patients because if there is bleeding or if it gets dislodged, it is easier to get to or control. Open
Quotation Transhepatic access makes the most sense because if there's bleeding or if it gets dislodged, particularly in pediatric patients, I Like it's easier to get to or control. Open
Statement For translumbar access, the operator locates the IVC at the lumbar level using CT, guides a needle down to get access, and then places the line. Open