Philips IGTD88901 User Manual Quick Guide: Iliac Venous Compression 16 5 224 Guide Rebrand

IGTD86700 Quick guide: Iliac venous compression Iliac%20Vein%20Compression%20Quick%20Guide Philips Volcano - Visions PV .018 Digital IVUS catheterIGTD86700

User Manual: Philips IGTD88901 Quick guide: iliac venous compression Philips Volcano - Visions PV .035 Digital IVUS catheterIGTD88901

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Quick reference

Venous

segment

Approximate

length

Approximate

diameter

Inferior Vena Cava 140 mm 23.4 mm

Common Iliac Vein 60 mm 16.0 mm

External Iliac Vein 130 mm 14.0 mm

Common Femoral Vein 60 mm 12.0 mm

Typical IVUS

imagery

Venous

anatomy

Approximate venous

segment dimensions

Ouriel K, Greenberg RK, Green RM, et al. A volumetric index for the quantification

of deep venous thrombosis. J Vasc Surg 1999;30:1060-6.

Raju S, Davis BS. Anomalous features of iliac vein stenosis that affect diagnosis and

treatment. J Vasc Surg: Venous and Lym Dis 2014;2:260-7.

Iliac venous

compression

Venous applications

Left iliac vein stent

Right iliac vein

Right iliac artery

Area of

compressed

left Iliac vein

Right iliac artery

Left iliac vein

Right iliac vein

Actual Size of

Field of View

(60mm)

Guide wire exit port

≤ 0.038" (0.97 mm)

90 cm working length

PIM connector

Y - connector

25 RO markers,

1 cm apart

7 F

8.2 F

transducer

Tip O.D.

≤

0.055”

30 cm GlyDx hydrophilic coating

© 2017 Koninklijke Philips N.V. All rights reserved.

Trademarks are the property of Koninklijke Philips

N.V. or their respective owners.

D000140310/A

Philips Volcano

3721 Valley Centre Drive, Suite 500

San Diego, CA 92130 USA

www.volcanocorp.com

1. Femoral or popliteal venous access

• Patient is therapeutically heparinized if not already

anticoagulated

• Insert a sheath through percutaneous or open access

site via standard interventional technique

2. Wire placement

• Advance an 0.035” guide wire to the area of interest

• An angled guide catheter may be used to facilitate

placement

3. Perform venogram of leg from access point to the level

of the diaphragm

• Place guide catheter in the cranial portion of the

femoral vein, just below the trochanter to image

the CFV, EIV, and CIV

• Advance guide catheter to EIV or CIV to image the IVC

4. Advancement of IVUS catheter

• Replace sheath with 9Fr introducer sheath

(8.5Fr minimum)

• Prepare the PV.035 IVUS catheter by ushing the guide

wire lumen, and then wipe down the entire working

length with sterile heparinized normal saline

• Connect the IVUS catheter to the imaging system’s

Patient Interface Module (PIM) as described in the

imaging system Operator’s Manual. Verify that the

device is imaging.

• Advance the IVUS catheter to the supra-renal IVC over

operator’s choice of 0.035” guide wire (wire exchanges

can be made through the IVUS catheter

at the Y-connector)

5. IVUS pullback for branch identication starting with

the renal veins

• Look for areas of narrowing due to compression or

hyperechoic scar from post-thrombotic change

• Evaluate the vein for any evidence of webbing

or spurs

• Measure cross-sectional area of narrowing, as well

as that of either side of narrowing; measure minimum

and maximum diameters at these points. Measure the

length of narrowed section using the Visions PV .035

IVUS catheter’s radiopaque or inked markers.

• Physician evaluates patient’s condition. Physician

decides whether it is medically necessary to intervene

and whether to proceed with venoplasty, venous

stenting or some other type of intervention.

• Venoplasty and venous stenting are illustrated in steps

6-7 of the workow. Post-intervention workow is

illustrated in steps 8-10. If no intervention is necessary,

proceed to Step 10.

6. Exchange the IVUS catheter for the physician’s choice

of angioplasty balloon, and treat the aected venous

segment(s)

7. Deploy the physician’s choice of stent to cover the area

requiring treatment

8. Perform post intervention IVUS assessment to assess

adequacy of stent apposition and proper dilation of the

venous segment(s)

9. Replace IVUS catheter with guide catheter and perform

nal venogram

10. Remove wire and sheath per standard interventional

procedure

CFV Common Fermoral Vein CIV Common Illiac Vein

EIV External Illiac Vein IVC Inferior Vena Cava

Visions PV .035 digital IVUS catheter

Workow

These workflow instructions were developed in consultation with Paul Gagne, MD (a paid Philips Volcano consultant) and are intended to serve as a general

reference guide for incorporating the use of IVUS into the diagnosis, and when medically necessary, the treatment and post intervention assessment of iliac venous

compression. They are not intended to replace the instructions for use of any medical device used in the procedure or the physician’s own workflow based upon

his/her medical experience and judgment.