Abstract No. 451 - A modified abdominal compression device to facilitate CT fluoroscopy-guided percutaneous interventions

Abstract

1.Provide indications for the use of an abdominal compression device to improve access to a target during CT fluoroscopy-guided interventions.2.Describe a modified commercially available fluoroscopic compression device.3.Provide cased-based-examples in which the abdominal compression device was used. CT-guided percutaneous abdominal interventions including biopsies and catheter drainages are common procedures in any interventional practice. While most targets, i.e. masses, lymph nodes, and fluid collections are readily accessible, many can be technically challenging due to intervening critical structures or may have a skin to target distance greater than the length of available needles. For structures that are relatively mobile, predominantly digestive and vascular organs, an abdominal compression device can be utilized to displace these structures, thereby creating a clear pathway to the intended target. Such a device can also employed to decrease the skin to target distance thereby allowing access to deeper targets. Abdominal compression devices have been described in the past, however have used materials which may not be readily available, require recreation of the device with every patient, or make manipulating the access needle relatively difficult. 1.Using an F-Spoon device, a slit and hole can be cut using a drill and saw into the spoon portion of the device.2.Intraprocedurally, the device is covered with a sterile ultrasound transducer cover and rubber bands making it sterile and reusable.3.The modified spoon portion can be employed as a compression device and to steer the needle without exposing the operator’s hand to the CT beam.4.After the procedure, the sterile cover is removed, the device cleaned, and reused for subsequent procedures.5.Provide several case examples illustrating the use of the abdominal compression device. 1.A fluoroscopic compression paddle can be easily modified into a device that facilitates CT fluoroscopy-guided percutaneous abdominal interventions.2.This device can be used to displace critical structures, shorten skin to target distance, and steer access needles while minimizing operator radiation dose.