Guidelines

Pre-procedure IR Guidelines

 

Procedure eDH Order Name
(IMG Code)
Modification if Anticoagulated Laboratories Required* Laboratory Timeframe Laboratory Cutoffs Antibiotic Prophylaxis Sedation Plan Follow-up References
Ablation Bone CT Guided Ablation
• Cryotherapy-Bone (4536)
• Microwave: Spine (4703)
• RFA: Bone (4572)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
osteoid osteoma : none.           cefazolin 2 g (3 g if ≥120 kg) OR
clindamycin 900 mg IV OR
vancomycin 15 mg/kg IV; max 2 g
General Anesthesia Chehab MA, et al.  Adult and pediatric antibiotic prophylaxis during vascular and IR Procedures A SIR practice parameter update…JVIR 2018;29:1483-1501
Kidney CT Guided Ablation
• Cryothreapy-Renal (4514)
• IRE: Renal (4605)
• Microwave: kidney (4629)
• RFA: renal (4404)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC, Cr
30 days INR ≤ 1.8
Platelets > 50
ceftriaxone 2 g IV General Anesthesia MR / CT Follow Up per Urology Gunn, Andrew J. et al., Society of Interventional Radiology Quality Improvement Standards on Percutaneous Ablation in Renal Cell Carcinoma . JVIR,  2020;31, 195 - 201.e3
Liver CT Guided Ablation
• Alcohol-Liver (4406)
• Cryotherapy-Liver (4513)
• IRE: Liver (4603)
• Microwave: liver (4628)
• RFA liver (4401)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
ampicillin-sulbactam 3 g IV
OR
ceftriaxone 2 g IV &
metronidazole 500 mg IV
General Anesthesia 2 month MR, or per Oncoligy / Liver Tumor Conference Seo, 2019:30:1895
Lung CT Guided Ablation:
• Cryotherapy-Lung (4537)
• Microwave-Chest (4627)
• RFA lung (4525)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
cefazolin 2 g (3 g if ≥120 kg) OR
clindamycin 900 mg IV OR
vancomycin 15 mg/kg IV; max 2 g
General Anesthesia Chehab MA, et al.  Adult and pediatric antibiotic prophylaxis during vascular and IR Procedures A SIR practice parameter update…JVIR 2018;29:1483-1501
Pancreas CT Guided Ablation
• IRE: pancreas (4604)
• RFA: pancreas (4403)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC w diff    CMP
30 days INR ≤ 1.5
Platelets > 100
ampicillin-sulbactam 3 g IV
OR
ceftriaxone 2 g IV &
metronidazole 500 mg IV
General Anesthesia Panfire, Radiology 2016
Soft Tissue CT Guided Ablation
• IRE Soft Tissue (4606)
• IRE: Other Site (4607)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
cefazolin 2 g (3 g if ≥120 kg) OR
clindamycin 900 mg IV OR
vancomycin 15 mg/kg IV; max 2 g
General Anesthesia Chehab MA, et al.  Adult and pediatric antibiotic prophylaxis during vascular and IR Procedures A SIR practice parameter update…JVIR 2018;29:1483-1501
Arteriogram Peripheral / Body Interventional IR Therasphere (Y-90) (6719) Check Specific Anticoagulant
"High Risk" Category
CMP
PTT / INR
CBC
2 weeks INR ≤ 1.8 fem, < 2.2 radial
Platelets > 50
None Moderate ACR-ABS-ACNM-ASTRO-SIR-SNMMI Practice Parameters for Selective Internal Radiation Therapy (SIRT) or Radioembolization for Treatment of Liver Malignancies Revised 2019 (Resolution 21)
IR Arterial Intervention (6670)
thrombolysis
IR Arteriogram:
• Bronchial (6714)
• GI bleed (6715)
• Liver bland (6706)
• Liver chemo (6704)
• Lower extremity (6742)
• Mesenteric (6743)
• Renal (6717)
• Upper Extremity (6745)
• Splenic (6724)
Check Specific Anticoagulant
"High Risk" Category
Creatinine
CBC
PTT / INR
30 days INR ≤ 1.8
Platelets > 50
Arterial endografts : cefazolin 2g IV

GI embo :  if hemobilia :  ceftriaxone 1g IV OR   ampicilli/sublactam 3g  IV OR  Vancomycin.

Splenic embo >70%: gent 10 mg/k/d, cefoxitin 100 mg/k/d x 5d

Moderate Chehab MA, et al.  Adult and pediatric antibiotic prophylaxis during vascular and IR Procedures A SIR practice parameter update…JVIR 2018;29:1483-1501 Khan, W., Sullivan, K.L., McCann, J.W. et al. Moxifloxacin prophylaxis for chemoembolization or embolization in patients with previous biliary interventions: a pilot study. AJR Am J Roentgenol. 2011; 197: 343–345
• Uterine Artery  (6720) Check Specific Anticoagulant
"High Risk" Category
Creatinine
CBC
PTT / INR
Urine Qualitative Pregnancy
30 days
(Except Urine Pregnancy, day of procedure)
INR ≤ 1.8 fem, < 2.2 radial
Platelets > 500
cefazolin 2 g (3 g if ≥120 kg) OR
clindamycin 900 mg IV + gentamicin 1.5 mg/kg OR
vancomycin 15 mg/kg IV; max 2 g
Moderate Chehab MA, et al.  Adult and pediatric antibiotic prophylaxis during vascular and IR Procedures A SIR practice parameter update…JVIR 2018;29:1483-1501
Petruzzi, N.J., McCann, J.W., Patel, N.A., and Gonsalves, C.F. Safety of uterine artery embolization in patients with preexisting hydrosalpinx. J Vasc Interv Radiol. 2012; 20: 796–799
Diagnostic IR arteriogram:
• Bronchial (6714)
• Hypogastric (6691)
• Lower Extremity (6742)
• Mesenteric (6743)
• Renal (6717)
• Renal artery (6673)
• Splenic (6724)
• Upper Extremity (6745)
IR therasphere pre (Y-90) (6721)
Check Specific Anticoagulant
"High Risk" Category
Creatinine
CBC
PTT / INR
30 days INR ≤ 1.8 fem, < 2.2 radial
Platelets > 50
None Moderate Chehab MA, et al.  Adult and pediatric antibiotic prophylaxis during vascular and IR Procedures A SIR practice parameter update…JVIR 2018;29:1483-1501
Neurologic Interventional IR Arterial Intervention (6670)
IR Embolization:
• Cerebral (6748)
• Extracranial (6644)
• Intracranial (6645)
• Middle Meningeal Unilateral (6778)
• Middle Meningeal Bilateral (6779)
Check Specific Anticoagulant
"High Risk" Category
Creatinine
CBC
PTT / INR
30 days INR ≤ 1.8
Platelets > 50
None General anesthesia or Moderate
Diagnostic IR Arteriogram:
• Cerebral (6741)
• Spinal (6744)
Check Specific Anticoagulant
"High Risk" Category
Creatinine
CBC
PTT / INR
30 days INR ≤ 1.8
Platelets > 50
none Moderate
Biopsy Superficial Palpable lesion, lymph node, soft tissue, breast, thyroid, superficial bone CT Guided Biopsy:
• Subcutaneous Mass (Chest, Abdomen, or Pelvis) (4687)
• Subcutaneous Mass (Extremities) (4688)
IR all biopsy procedures (6636)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Local or Fentanyl
Deep Visceral Organ, Bone, Deep Abdominal, etc. CT Guided Biopsy:
• Abdominal (4564)
• Adrenal (4565)
• Liver (4434)
• Lung (4432)
• Lymph Node (Chest, Abdomen, or Pelvis) (4686)
• Mediastinum (4685)
• Other (4676)
• Pancreas (4444)
• Peritoneal / Omental (4654)
• Pleura (4581)
• Renal (4452)
• Retroperitoneal (4456)
• Spleen (4695)
IR all biopsy procedures (6636)
IR biopsy lymph node chest / abdomen / pelvis (6775)
IR biopsy liver percutaneous (6701)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
None Moderate
Transjugular Transjugular liver IR biopsy liver transjugular (6703) Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Moderate
Central Venous Access
(CVC)
Catheter Removals IR line/tube removal in recovery room (6688)
IR mediport removal (6700)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Local Ideally;
Mediport Removal Option of Patient (Local, Fentanyl, or Moderate)
Non-tunneled venous access placement IR dialysis access - temporary line (6767)
IR temporary venous access non-dialysis (6707)
IR PICC placement (6757)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Local or Fentanyl
Tunneled venous catheter placement IR dialysis access - tunneled line (6639)
IR central venous access - tunneled non-dialysis (6662)
IR mediport placement/exchange (6676)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
    None   OR                                 cefazolin 2 g IV    OR
clindamycin 900 mg IV OR
vancomycin 15 mg/kg IV; max 2g
Moderate Johnson, E.  JVIR 2016;27:339-343.
Drainage & Subsequent Catheter Interventions Abscess Drainage / Aspiration - Superficial CT Guided Aspiration (149)
CT Guided Aspiration Fine Needle (4673)
IR all drainage procedures (6642)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
Location-dependent. Only if not already on. Local or Fentanyl Abscess: 2-4 weeks
Abscess Drainage / Aspiration - Deep
(Lung, Abdominal, Pelvic, Retroperitoneal)
CT Guided Aspiration (149)
CT Guided Aspiration:
• Disc (4594)
• Fine Needle (4673)
• Liver (4576)
• Other (4675)
• Pancreas (4578)
• Peritoneal (4450)
• Renal (4451)
• Retroperitoneal (4455)
CT Guided Drain (190)
CT Guided Drain:
• Abdomen (321)
• Chest Tube / Pleural Drain (4415)
• Liver (4431)
• Lung (4567)
• Muscle (4570)
• Other (4677)
• Ovarian Abscess (4657)
• Ovarian Cyst (4656)
• Pancreatic (4521)
• Peritoneal (238)
• Peritoneal (Transrectal or Transvaginal) (4672)
• Renal Abscess (4526)
• Retroperitoneal Abscess (4457)
CT Guided Sclerotherapy (4632)
IR all drainage procedures (6642)
IR endocavitary drain placement (6725)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
Location-dependent. Only if not already on.                     Intraabdominal: meropenem OR piperacillin/tazobactam OR metronidazole + ciprofloxacin Moderate Abscess: 2-4 weeks Chehab MA, et al.  Adult and pediatric antibiotic prophylaxis during vascular and IR Procedures A SIR practice parameter update…JVIR 2018;29:1483-1501 Fadl JVIR 2015;26:539
Catheter exchanges (abscess, biliary, gastrostomy, G/GJ conversions, nephrostomy) IR drain check/change/remove (6702)
IR biliary tube check/change/remove (6635)
IR chait/cecostomy tube replace/exchange (6681)
IR G-tube check/change (6751)
IR GJ-tube check/change (6749)
IR nephrostogram/nephrostomy tube exchange (6753)
IR nephroureteral (nu) stent placement/check/change (6756)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
Nephrostomy or nephroureteral catheter: ciprofloxacin 500 mg PO Local or Fentanyl Biliary: 6-8 weeks
Nephrostomy: 1-3 months
Nephroureteral: 1-3 months
Non-tunneled chest drains IR chest tube placement (6675) Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Fentanyl
Paracentesis CT Guided Paracentesis (4671)
IR paracentesis (6695)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Local albumin 6-8 g / liter removed:  European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53:397–417.
Thoracentesis CT Guided Thoracentesis (4469)
IR thoracentesis (6696)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Fentanyl
Tunneled drainage catheter (Peritoneal / Pleural PleurX) and removal IR pleurx drain placement abdominal (6758)
IR pleurx drain placement thoracic (6759)
IR pleurx drain removal (6722)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
cefazolin 2 g (3 g if ≥120 kg) OR
clindamycin 900 mg IV OR
vancomycin 15 mg/kg IV; max 2g.  REMOVAL : None
Moderate
Enteric Access (GI) Gastrostomy or gastrojejunostomy catheter placements CT Guided Drain Chait Tube (4569)
CT Guided Drain Gastrostomy (4697)
CT Guided Inserion of G-Tube (4666)
IR G-tube placement (6752)
IR GJ-tube placement (6750)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
cefazolin 2 g (3 g if ≥120 kg) OR
clindamycin 900 mg IV OR
vancomycin 15 mg/kg IV; max 2g
Moderate 2 wk gastropexy release
6 mo gastrojejunal change
Ingraham JVIR 2018;29:55
Simple Exchanges See "Drains" within the "Catheter Exchanges" Section
Genitourinary
(GU)
Urinary Drain Placements or Interventions
(nephrostomy tube placement, ureteroplasty, stone removal)
CT Guided Aspiration Bladder (4659, 4660)
CT Guided Drain Nephrostomy (4698)
CT Guided Nephrostomy Placement (4658 or 4663)
CT Guided Nephrostomy Dilitation (4664)
IR nephrostomy tube placement percutaneous (6709)
IR nephroureteral (nu) stent placement / check / change (6756)
IR suprapubic cath placement (6708)
IR suprapubic cath upsize (6760)
IR ureteroplasty (6790)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
Ciprofloxacin 400 mg IV
OR
Ceftriaxone 2 g IV
OR
ampicillin/sublactam 3 g IV
Moderate Nephrostomy: 3 months
Nephroureteral: 6 months
Ureteroplasty: 1 month
Simple Exchanges See "Drains" within the "Catheter Exchanges" Section
Hepatobiliary Cholecystostomy Placement CT Guided Cholecystostomy (4696 / 4670)
IR Cholecystostomy Tube Placement (6711)
Check Specific Anticoagulant
"High Risk" Category
CMP
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
piperacillin-tazobactam 3.375 g IV
OR
ceftriaxone 2 g IV &
metronidazole 500 mg IV
Moderate 6-week Evaluation Chehab MA,,JVIR 2018;29:1483-1501
Percutaneous Transhepatic Cholangiography Placement or Revision CT Guided Drain Biliary (4665)
IR Transhepatic Cholangiogram Percutaneous (6683)
Check Specific Anticoagulant
"High Risk" Category
CMP
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
piperacillin-tazobactam 3.375 g IV
OR
ceftriaxone 2 g IV &
metronidazole 500 mg IV
Pleacement: General Anesethia Chehab MA,,JVIR 2018;29:1483-1501
Biliary Subsequent Interventions Simple Exchanges See "Drains" within the "Catheter Exchanges" Section
Portal Vein Interventions IR portal vein recanalization / embolization (6718) Check Specific Anticoagulant
"High Risk" Category
CMP
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
ampicillin-sulbactam 3 g IV
OR
ceftriaxone 2 g IV &
metronidazole 500 mg IV
Moderate
TIPS Placement IR TIPS(6660) Check Specific Anticoagulant
"High Risk" Category
CMP
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
ampicillin-sulbactam 3 g IV
OR
ceftriaxone 2 g IV &
metronidazole 500 mg IV
General Anesthesia 2 week US
Revision IR TIPS revision (6684) Check Specific Anticoagulant
"High Risk" Category
CMP
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
ampicillin-sulbactam 3 g IV
OR
ceftriaxone 2 g IV &
metronidazole 500 mg IV
Moderate
Musculoskeletal
(MSK)
Aspirations & Drainages CT Guided Aspiration:
• Ganglion Cyst (1126)
• Joint - Large Left (4689)
• Joint - Large Right (4690)
• Joint - Medium Left (4691)
• Joint - Medium Right (4692)
• Joint - Small Left (4693)
• Joint - Small Right (4694)
• Muscle (4575)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Local
Biopsy CT Guided Biopsy:
• Bone (Extremity / Pelvis) (4408)
• Bone (Spine / Skull) (4684)
• Bone Marrow (4655)
• Bone Superficial (4669)
• Muscle (Chest, Abdomen, or Pelvis) (4436)
• Muscle (Extremities) (4699)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
None Moderate
Joint and Musculoskeletal Injections CT Guided Joint Injection (4554)
CT Guided Injection:
• Piriformis (4712)
• Tendon (4558)
• Tendon Sheath (4557)
XR fluoro arthrogram:
• ankle (2567)
• hip (2565)
• wrist (2635)
XR fluoro guided joint injection:
• small (2631)
• medium (2630)
• large (2628)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Local
Neurologic
(Neuro)
Non-vascular Biopsy - Superficial IR Biopsy:
• lymph node head/neck (6699)
• parotid (6727)
• soft tissue neck mass (6788)
• thyroid FNA (6698)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Local or Fentanyl
Biopsy - Deep CT Guided Biopsy:
• Lymph Node (Head or Neck) (4435)
• Salivary Gland (4571)
• Thyroid (4566)
IR all biopsy procedures (6636)
IR aspiration disc (6746)
IR biopsy spine (6747)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
None Moderate
Drainages & Aspriations CT Guided Aspiration:
• Disc (4594)
• Synovial Cyst (4592)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
None Moderate
Lumbar puncture IR fluoro lumbar puncture (1111)
IR lumbar puncture/myelogram recovery (6687)
Check Specific Anticoagulant
"Low Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
None Local
Joint Injections CT Guided Injection:
• Epidural Steroid - Lumbar (4711)
• SI Joint (4461)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
cefazolin 2 g (3 g if ≥120 kg) OR
clindamycin 900 mg IV OR
vancomycin 15 mg/kg IV; max 2 g
Moderate
Nerve Blocks - Peripheral XR fluoro guided joint injection:
• small (2631)
• medium (2630)
• large (2628)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Local
Nerve Blocks - Paraspinal CT Guided Nerve Block:
• Cervical Multiple Levels (4647)
• Cervical Single Level (4441)
• Lumbar Multiple Levels (4438)
• Lumbar Single Level (4442)
• Suprascapular (4640)
• Thoracic Multiple Levels (4634)
• Thoracic Single Level (4633)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
cefazolin 2 g (3 g if ≥120 kg) OR
clindamycin 900 mg IV OR
vancomycin 15 mg/kg IV; max 2 g
Moderate
Spine procedures with risk of spinal or epidural hematoma (vertebroplasty, epidural injections, c-spine facet blocks) CT Guided Sacroplasty / Vertebroplasty (4551)
IR vertebral augmentation lumbar
• single (6780)
• multiple (6782)
IR vertebral augmentation thoracic
• single (6781)
• multiple (6783)
IR vertebroplasty lumbar
• single (6772)
• multiple (6773)
IR vertebroplasty thoracic
• single (6761)
• multiple (6762)
Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
cefazolin 2 g (3 g if ≥120 kg) OR
clindamycin 900 mg IV OR
vancomycin 15 mg/kg IV; max 2 g
Moderate Shaffer, W.O., Baisden, J.L., Fernand, R., Matz, P.G., and North American Spine Society. An evidence-based clinical guideline for antibiotic prophylaxis in spine surgery. Spine J. 2013; 13: 1387–1392
Filter IVC filter removal (complex) IR IVC filter removal (6716) Check Specific Anticoagulant
"High Risk" Category
PTT / INR
CBC
30 days INR ≤ 1.8
Platelets > 50
None Moderate
IVC filter placement or removal (simple) IR IVC filter placement or svc (6650)
IR IVC filter removal (6716)
IR IVC filter check (6793)
Check Specific Anticoagulant
"Low Risk" Category
None per procedure protocol* INR ≤ 3.0
Platelets > 20
None Moderate Placement - 3 month Clinic Phone Call Chehab MA, et al.  Adult and pediatric antibiotic prophylaxis during vascular and IR Procedures A SIR practice parameter update…JVIR 2018;29:1483-1501
Venogram & Lymphangiogram Diagnostic Diagnostic venography and lymphangiography IR adrenal vein sampling (6713)
IR venogram (6769)
IR lymphangiogram (6785)
none none 30 days INR ≤ 3.0
Platelets > 20
None Moderate except for non-intervention venogram (local only) Chehab MA, et al.  Adult and pediatric antibiotic prophylaxis during vascular and IR Procedures A SIR practice parameter update…JVIR 2018;29:1483-1501
Intervention pelvic and extremity interventions varicocele embolization
IR varicose vein ablation (6705)
Check Specific Anticoagulant
"Low Risk" Category
Creatinine
CBC
PTT / INR
30 days INR ≤ 3.0
Platelets > 20
None Moderate Chehab MA,,JVIR 2018;29:1483-1501
Portal vein/TIPS see "Hepatobiliary" section
Catheter directed thrombolysis (DVT, PE, portal vein) IR venous intervention aka thrombolysis (6663) Check Specific Anticoagulant
"High Risk" Category
Creatinine
PTT / INR
CBC
Fibrinogen
30 days INR ≤ 1.8
Platelets > 50
None Moderate
Venous interventions (intra-thoracic and CNS) IR venous intervention (6663) Check Specific Anticoagulant
"High Risk" Category
Creatinine
CBC
PTT / INR
30 days INR ≤ 1.8
Platelets > 50
None Moderate
Sclerotherapy venous malformation Check Specific Anticoagulant
"Low Risk" Category
none na INR ≤ 3.0
Platelets > 20
cefazolin 2 g (3 g if ≥120 kg) OR
clindamycin 900 mg IV + gentamicin 1.5 mg/kg OR
vancomycin 15 mg/kg IV; max 2 g. PEDS:  Cefazolin 25 mg/keg
Moderate Chehab MA, et al.  Adult and pediatric antibiotic prophylaxis during vascular and IR Procedures A SIR practice parameter update…JVIR 2018;29:1483-1501
Dialysis Hemodialysis Access interventions IR dialysis access - AV fistula evaluations (6640) Check Specific Anticoagulant
"Low Risk" Category
If missed HD, K Day of procedure INR ≤ 3.0
Platelets > 20
None Moderate Chehab
Unless otherwise noted:
Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions—Part II: Recommendations
Patel, Indravadan J. et al.  JVIR,  2019; 30:1168 - 1184.e1