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  • VASCULAR ACCESS (Edited)

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    Asep Fauzi
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    This document discusses vascular access during cardiac catheterization. It describes the arterial and venous access points used, which include the femoral, radial, brachial, and ulnar arteries as well as the femoral, internal jugular, and subclavian veins. It outlines the locations for puncture, potential complications, and hemostasis techniques. Femoral access is described in more detail, including anatomy, risk factors for complications like hematoma and pseudoaneurysm, and manual compression and closure devices used for hemostasis. Radial access is also summarized, covering the puncture area, risks like spasm and bleeding, and hemostasis for the radial artery.

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    This document discusses vascular access during cardiac catheterization. It describes the arterial and venous access points used, which include the femoral, radial, brachial, and ulnar arteries as well as the femoral, internal jugular, and subclavian veins. It outlines the locations for puncture, potential complications, and hemostasis techniques. Femoral access is described in more detail, including anatomy, risk factors for complications like hematoma and pseudoaneurysm, and manual compression and closure devices used for hemostasis. Radial access is also summarized, covering the puncture area, risks like spasm and bleeding, and hemostasis for the radial artery.

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    © All Rights Reserved
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    61 views35 pages

    VASCULAR ACCESS (Edited)

    Uploaded by

    Asep Fauzi
    This document discusses vascular access during cardiac catheterization. It describes the arterial and venous access points used, which include the femoral, radial, brachial, and ulnar arteries as well as the femoral, internal jugular, and subclavian veins. It outlines the locations for puncture, potential complications, and hemostasis techniques. Femoral access is described in more detail, including anatomy, risk factors for complications like hematoma and pseudoaneurysm, and manual compression and closure devices used for hemostasis. Radial access is also summarized, covering the puncture area, risks like spasm and bleeding, and hemostasis for the radial artery.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
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    of 35

    Vascular Access during Cardiac

    Catheterization
    DIAGNOSTIK INVASIF DAN INTERVENSI NON BEDAH
    RSUP DR HASAN SADIKIN
    BANDUNG

    1
    M. Ismet Kuswanda
    VASCULAR ACCESS

    ARTERIAL VENOUS

    2
    ARTERIAL

    FEMORAL RADIAL BRACHIAL ULNAR

    3
    VENOUS

    FEMORAL IJV SUBCLAVIAN

    4
    TOPIK 5

     LOKASI PENUSUKAN
     KOMPLIKASI
     HEMOSTASIS
    FEMORAL ACCESS - 6

    ANATOMY
    7

    • Area Penusukan
    • Arteri femoral
    • 2 cm di bawah inguinal ligament.
    KOMPLIKASI 8

     VASCULAR  NON VASCULAR


     Hematoma  Infeksi
     Pseudo-aneurysm
     A-V fistula
     Retropertonial
    hemorrhage
     Thrombosis
    9

    • A contained rupture; with disruption of all 3 layers of the


    arterial wall.
    • Occur when an arterial puncture site does not adequately
    seal.
    • Pulsatile blood tracks into the perivascular space and is
    contained by the perivascular structures, which then take
    on the appearance of a sac.
    10

    • High puncture
    • Inadvertent puncture of the posterior wall of the femoral or iliac
    artery
    • Exacerbated by the fact that patients receive antiplatelets,
    anticoagulants
    • Removal of catheter without wire
    11
    FAKTOR RESIKO 12

     Area Penusukan
     Ukuran dari Sheath
     Pencabutan Sheath
     Obat-Obatan
    HEMOSTASIS 13

    VASCULAR ACCESS,COMPLICATIONS,MERITS
     Penekanan secara manual
     Penekanan dengan alat
     Vascular closure device
    • PENEKANAN MANUAL ARTERI FEMORALIS
    14
    • Waktu
    • Prosedur diagnostik secepatnya
    • Interventions - 4-6 hrs, ACT < 170 sec
    • Lokasi
    • 2 cm proksimal lokasi penusukan
    • Durasi
    • 15 – 30 min, tergantung ukuran Sheath
    • Kerugian
    • Pada pasien yang gemuk, penekanan manual kurang efektif
    15
    16
    PENEKANAN DENGAN 17

    ALAT

    Keuntungan
    • Penekanan lebih efektif
    Kerugian
    • Pasien tidak nyaman
    VASCULAR CLOSURE DEVICE
    ANGIO-SEAL
    STAR CLOSE DEVICE
    PERCLOSE SUTURE DEVICE
    RADIAL ACCESS 22
    23
    AREA PENUSUKAN 24
    25
    BARBEAU TEST 26
    KOMPLIKASI
    27

     Spasm
     Perdarahan
     Hematoma
     Perforasi dan Diseksi
     AV Fistula
     Pseudo-aneurysm
     Infeksi
    • KOMPLIKASI SAAT PROSEDUR
    28
    • Reaksi Vaso Vagal
    • Spasm
    • Perforasi
    • Diseksi

    • POST PROCEDURE
    • Hematoma
    • Oklusi
    • Pseudoaneurysm
    29

    VASCULAR ACCESS,COMPLICATIONS,MERITS
    30

    VASCULAR ACCESS,COMPLICATIONS,MERITS
    31

    VASCULAR ACCESS,COMPLICATIONS,MERITS
    Hemostasis Radial 32
    33
    34
    35

    TERIMA KASIH

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