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 |
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| 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) |
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| 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 |
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| 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 |
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| 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 | ||||||||||||