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Ct-guided alcohol ablation of pelvic cyst

chembree

Guru
Messages
243
Location
Dallas, GA
Best answers
0
CT-GUIDED ALCOHOL ABLATION OF PELVIC CYST


The procedure was performed under CT guidance (77013). A Yueh catheter was used from a percutaneous approach to aspirate the cyst. Then the report states the cyst was injected with 60 ml of diluted Isovue. The patient was then rotated. Multiple axial images of the pelvis were obtained from the iliac crest to the symphysis pubis.

Post Contrast injection images demonstrate contrast within a smaller left pelvic cyst. However, there is no evidence of contrast leak or extravasation. Therefore, contrast aspiration from the cyst was attempted utilizing the Yueh catheter. However, the tip of the catheter retracted from the cyst during the rotation of the patient. The catheter was then removed.

Under CT Guidance, a 22- gage Chiba needle was advanced from an anterior pelvic wall approach and into the left pelvic cyst now opacified with contrast. Needle tip positioned within the cyst was confirmed with CT imaging. Contrast was aspirated from the cyst to completion through the Chiba needle. This was then followed by injection of 5 ml of 1% lidocaine without epinephrine into the cyst. The lidocaine was allowed to stay within the cyst for approximately 10 minutes. The lidocaine was then aspirated. This was then followed by injection of 15 ml of 98% alcohol through the Chiba needle directly into the cyst. The needle was then removed. The patient was rotated twice immediately post injection of alcohol within the left pelvic cyst. No complications were encountered.
 

donnajrichmond

True Blue
Messages
518
Location
Alexandria, LA
Best answers
0
CT-GUIDED ALCOHOL ABLATION OF PELVIC CYST


The procedure was performed under CT guidance (77013). A Yueh catheter was used from a percutaneous approach to aspirate the cyst. Then the report states the cyst was injected with 60 ml of diluted Isovue. The patient was then rotated. Multiple axial images of the pelvis were obtained from the iliac crest to the symphysis pubis.

Post Contrast injection images demonstrate contrast within a smaller left pelvic cyst. However, there is no evidence of contrast leak or extravasation. Therefore, contrast aspiration from the cyst was attempted utilizing the Yueh catheter. However, the tip of the catheter retracted from the cyst during the rotation of the patient. The catheter was then removed.

Under CT Guidance, a 22- gage Chiba needle was advanced from an anterior pelvic wall approach and into the left pelvic cyst now opacified with contrast. Needle tip positioned within the cyst was confirmed with CT imaging. Contrast was aspirated from the cyst to completion through the Chiba needle. This was then followed by injection of 5 ml of 1% lidocaine without epinephrine into the cyst. The lidocaine was allowed to stay within the cyst for approximately 10 minutes. The lidocaine was then aspirated. This was then followed by injection of 15 ml of 98% alcohol through the Chiba needle directly into the cyst. The needle was then removed. The patient was rotated twice immediately post injection of alcohol within the left pelvic cyst. No complications were encountered.
SIR has suggested using 20500 for the injection into a cyst for sclerosis.
 
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