Mynx Grip Vascular Closure Device

There are a lot of closure devices. I picked this one next because we use this and I wanted to understand how to do it, and what is actually going on when I’m doing something. The first picture is of the device. Not the most glamorous shot, but I was trying to get it in

Parallax

The term kind of sounds like a superhero or villain. Their super power is to alter perspective. Almost sounds like mind control, or the power of illusion. Maybe Parallax can be a magician like Doctor Strange. Edit: upon further review there already is a comic book villain in the DC universe called Parallax. Anyway, parallax

Fluoroscopy vs CT Considerations When Placing Screws

Placement of screws during spine surgery is a common practice. The manner in which the screws are placed can range from “free hand” where a surgeon cannulates the desired path by feel and then subsequently places the screw to using intraoperative navigation. Today’s post is about the differences in images obtained from fluoroscopy and CT.

Perforator Drill Bit

Early on in neurosurgery residency, we are introduced to something called a perforator drill. This is a relatively safe drill bit because it is meant to create a burr hole in the skull and automatically stop before the dura. It’s supposed to be safe, but as residents we always find a way to make attendings

Fluoroscopy License

Below was the process pre-COVID (2019ish?) California Supervisor and Operator Permit Apply for permit Register to take Exam Take the California Department of Public Health – Radiologic Health Branch test Apply for Permit Submit California Licentiate Supervisor and Operator Permit Application Select “Fluoroscopy Supervisor and Operator Permit” Need a copy of California Physician license Takes

Hydrophilic vs Hydrophobic?

Hydrophilic versus hydrophobic coated catheters What the heck? If there are different types there must be a reason. How badly do I want to know what the difference is? Generically I’m sure readers of this site understand hydrophilic refers to substances that are attracted to water and hydrophobic refers to substances that are not attracted

Heparinized Saline

Heparinized saline is often used as a constant flush through the catheters to avoid thrombus formation. There is no standard concentration across the country. There may be standards within an institution, but there have been no studies to define a gold standard or standard of care. Some practitioners will just use saline. At one of

Angioseal Closure Device

I have no financial stake in this product or company. I just chose this one first since it’s a common closure device used at our facility. Below I’ve assigned names to the parts and that is how they’re referenced in the descriptors for steps. Place locator through angioseal sheath. There is an audible click with

Biplane Controls

Biplane controls (Philips) If you’re not the person manipulating the catheters or guide wires it is unlikely you will be manipulating the controls for the table or stepping on the peddle to obtain images. In order to step on the peddle, depending on the state, you will need to have a current fluoro license (another

Common Femoral Access

I speak about common femoral access because that is currently what is most often used at the hospitals I’ve rotated at. As with anything there are variations in techniques so what I present is not what HAS to be done but what I have seen done so that I can be prepared for the next