SECTION 1: GENERAL PRINCIPLES PROCEDURAL CONSIDERATIONS 4 Pharmacologics Chad Davis, MD and Brandt C. Wible, MD 10 Procedural Patient Management Amanda L. Scott, DO, Kenneth H. Cho, MD, MBA, and Keith B. Quencer, MD 18 Radiation Safety Chad Davis, MD and Brandt C. Wible, MD PROCEDURAL TECHNIQUES 22 Angioplasty Brandt C. Wible, MD and T. Gregory Walker, MD, FSIR 30 Thrombolysis and Thrombectomy Brandt C. Wible, MD and T. Gregory Walker, MD, FSIR 42 Embolization Brandt C. Wible, MD and T. Gregory Walker, MD, FSIR 54 Stents: Vascular Brandt C. Wible, MD 66 Stents: Nonvascular Brandt C. Wible, MD 70 Embolic Protection T.Gregory Walker, MD, FSIR 78 Atherectomy T.Gregory Walker, MD, FSIR and Brandt C. Wible, MD SECTION 2: VENOUS, PORTAL, ANDLYMPHATIC PROCEDURES VENOUS ACCESS 86 Venous Access Anatoly Loskutov, MD and Brandt C. Wible, MD 100 Peripherally Inserted Central Catheters Anatoly Loskutov, MD and Brandt C. Wible, MD 106 Catheters, Nontunneled and Tunneled Anatoly Loskutov, MD and Brandt C. Wible, MD 120 Ports Anatoly Loskutov, MD and Brandt C. Wible, MD VENOUS INTERVENTIONS 130 Thoracic Central Venous Intervention Brandt C. Wible, MD, Scott M. Brannan, MD, and Stephan Wicky, MD 144 Lower Extremity and Iliocaval Intervention Brandt C. Wible, MD 158 Vena Cava Filter Placement and Retrieval Brandt C. Wible, MD and Nathan Saucier, MD 170 Foreign Body Retrieval Chad Davis, MD and Brandt C. Wible, MD 174 Pelvic Venous Disorders (PeVD) Jennifer R. Buckley, MD, MBA and Brandt C. Wible, MD 188 Renal and Adrenal Veins: Sampling and Intervention Keith B. Quencer, MD 198 Venous Sampling and Venography: Endocrine, Nonadrenal Keith B. Quencer, MD, T. Gregory Walker, MD, FSIR, and Brandt C. Wible, MD 202 Ambulatory Phlebectomy and Sclerotherapy Joseph A. Ronsivalle, DO, FSIR 206 Saphenous Vein Ablation Joseph A. Ronsivalle, DO, FSIR 214 Vascular Malformations Scott R. Shuldiner, MD, Christopher Bailey, MD, and Clifford R. Weiss, MD, FSIR HEMODIALYSIS ACCESS MAINTENANCE 224 Hemodialysis Access Surveillance and Intervention Keith B. Quencer, MD 238 Hemodialysis Access Declotting Procedures Keith B. Quencer, MD and Steven Wu, MD 246 Peritoneal Dialysis Catheter Placement Keith B. Quencer, MD PORTAL VENOUS INTERVENTIONS 258 Transjugular Biopsy Jennifer R. Buckley, MD, MBA and Nathan Saucier, MD 262 TIPS Brandt C. Wible, MD, Nathan Saucier, MD, and Suvranu Ganguli, MD 276 Balloon Occlusion Variceal Ablation Brandt C. Wible, MD 286 Portal Vein Embolization Wylie T. Foss, MD, Joshua Kuban, MD, and Nathan Saucier, MD 294 Portal and Hepatic Venous Intervention Ethan Yiyang Lin, MD, Joshua Kuban, MD, and Jennifer R. Buckley, MD, MBA LYMPHATIC INTERVENTIONS 306 Lymphography Nikhil Bhagat, MD and Suvranu Ganguli, MD 310 Thoracic Duct Embolization Nikhil Bhagat, MD and Suvranu Ganguli, MD SECTION 3: ARTERIAL PROCEDURES GENERAL CONSIDERATIONS 316 Arterial Access Chad Davis, MD and Brandt C. Wible, MD 326 Closure Devices Brandt C. Wible, MD, Derek S. Vien, MD, and T. Gregory Walker, MD, FSIR 332 Access Site Complications Management Jennifer R. Buckley, MD, MBA and Brandt C. Wible, MD AORTA 338 Thoracic Aorta and Great Vessels Brandt C. Wible, MD and Zubin Irani, MD 348 Abdominal Aorta T.Gregory Walker, MD, FSIR 358 Thoracic Aortic Endografts T.Gregory Walker, MD, FSIR, Brandt C. Wible, MD, and Zubin Irani, MD 368 Abdominal Aortic Endografts T.Gregory Walker, MD, FSIR 380 Endoleak Repair T.Gregory Walker, MD, FSIR PULMONARY VASCULATURE 392 Pulmonary Embolism Jennifer R. Buckley, MD, MBA and Brandt C. Wible, MD 402 Pulmonary Arteriovenous Malformations Jennifer R. Buckley, MD, MBA, Christopher Bailey, MD, and Clifford R. Weiss, MD, FSIR 412 Bronchial Arteries Brandt C. Wible, MD, Mandeep S. Dagli, MD, and T. Gregory Walker, MD, FSIR ABDOMEN AND PELVIS 420 Upper Gastrointestinal Hemorrhage Andrew Kolarich, Yvonne Tsitsiou, and Christos Georgiades, MD, PhD 434 Lower Gastrointestinal Hemorrhage Andrew Kolarich, Yvonne Tsitsiou, and Christos Georgiades, MD, PhD 448 Mesenteric Ischemia Brandt C. Wible, MD and Raymond W. Liu, MD 462 Visceral Arteries T.Gregory Walker, MD, FSIR, Franklin Nwoke, MD, and Raymond W. Liu, MD 472 Renal Arteries: Revascularization and Exclusion Keith B. Quencer, MD and T. Gregory Walker, MD, FSIR 496 Pelvic Arteries: Revascularization T.Gregory Walker, MD, FSIR 508 Pelvic Arteries: Exclusion T.Gregory Walker, MD, FSIR 520 Uterine Artery Embolization Jennifer R. Buckley, MD, MBA and Brandt C. Wible, MD EXTREMITIES 530 Upper Extremity: Vasculitis and Revascularization T.Gregory Walker, MD, FSIR, Brandt C. Wible, MD, and Zubin Irani, MD 540 Upper Extremity Arteries: Exclusion T.Gregory Walker, MD, FSIR and Zubin Irani, MD 546 Infrainguinal Arteries: Revascularization Keith B. Quencer, MD and T. Gregory Walker, MD, FSIR 556 Infrainguinal Arteries: Exclusion Keith B. Quencer, MD and T. Gregory Walker, MD, FSIR 564 Chronic Total Occlusion Revascularization T.Gregory Walker, MD, FSIR CRANIAL REVASCULARIZATION 576 Stroke Therapy Jared Halpin, MD and Coleman O. Martin, MD 584 Carotid and Vertebral Arteries Jared Halpin, MD, Coleman O. Martin, MD, and T. Gregory Walker, MD, FSIR SECTION 4: NONVASCULARPROCEDURES GENERAL CONSIDERATIONS 594 Biopsy Procedures Jennifer R. Buckley, MD, MBA and Brandt C. Wible, MD 608 Drainage Procedures Jennifer R. Buckley, MD, MBA and Brandt C. Wible, MD GASTROINTESTINAL INTERVENTIONS 628 Gastrostomy/Gastrojejunostomy Brandt C. Wible, MD 640 Gastrointestinal Balloon Dilatation and Stenting Brandt C. Wible, MD and Ashraf Thabet, MD BILIARY INTERVENTIONS 646 Transhepatic Biliary Interventions Amanda L. Scott, DO, Kenneth H. Cho, MD, MBA, and Brian Holly, MD 656 Cholecystostomy Conrad Pun, MD and Lara Mrak, MD, PhD GENITOURINARY INTERVENTIONS 662 Genitourinary Interventions Jennifer R. Buckley, MD, MBA, Brandt C. Wible, MD, and Ashraf Thabet, MD 676 Fertility and Sterility Interventions Jennifer R. Buckley, MD, MBA and Brandt C. Wible, MD SPINAL INTERVENTIONS 682 Lumbar Puncture, Myelogram, and CSF Leaks Brandt C. Wible, MD, Ross Holwerda, MD, and Coleman O. Martin, MD 686 Vertebral Augmentation and Sacroplasty Brandt C. Wible, MD SECTION 5: ONCOLOGIC PROCEDURES 700 Percutaneous Tumor Ablation Nicolas Cardenas, MD, Jessica L. Burris, BS, and Joshua Kuban, MD 716 Hepatic Chemoembolization Chad Davis, MD and Mandeep S. Dagli, MD 728 Hepatic Radioembolization Chad Davis, MD 740 Renal Ablation and Embolization Joseph A. Ronsivalle, DO, FSIR and Ashraf Thabet, MD 750 Thoracic Ablation and Embolization Jennifer R. Buckley, MD, MBA, Brandt C. Wible, MD, and Ashraf Thabet, MD 758 Musculoskeletal Ablation and Embolization Brandt C. Wible, MD and Ashraf Thabet, MD SECTION 6: POSTTRANSPLANTPROCEDURES 766 Transplant Kidney Procedures Brandt C. Wible, MD, Lee Saville Cummings, MD, and Matthew B. Wilkinson, MD, PhD 778 Transplant Liver Procedures Brandt C. Wible, MD, Matthew B. Wilkinson, MD, PhD, and Lee Saville Cummings, MD SECTION 7: PAIN MANAGEMENT 790 Transforaminal Nerve Blocks Jennifer R. Buckley, MD, MBA, Conrad Pun, MD, and Donald V. La Barge, III, MD, MBA 796 Facet Blocks Jennifer R. Buckley, MD, MBA, Conrad Pun, MD, and Donald V. La Barge, III, MD, MBA 802 Celiac Plexus Block Jennifer R. Buckley, MD, MBA and Brandt C. Wible, MD SECTION 8: MUSCULOSKELETALPROCEDURES 810 Shoulder Arthrography Brandt C. Wible, MD, A. Keith Rastogi, MD, and Julia R. Crim, MD 814 Elbow Arthrography Brandt C. Wible, MD, Jessica Sanchez, MD, and Julia R. Crim, MD 818 Wrist Arthrography Brandt C. Wible, MD, A. Keith Rastogi, MD, and Julia R. Crim, MD 822 Sacroiliac Joint Arthrography Brandt C. Wible, MD, A. Keith Rastogi, MD, and Julia R. Crim, MD 824 Hip Arthrography Brandt C. Wible, MD, Jessica Sanchez, MD, and Julia R. Crim, MD 830 Knee Arthrography Brandt C. Wible, MD, Jessica Sanchez, MD, and Julia R. Crim, MD 834 Ankle Arthrography Brandt C. Wible, MD, A. Keith Rastogi, MD, and Julia R. Crim, MD 838 Foot Arthrography Brandt C. Wible, MD, Julia R. Crim, MD, and Jessica Sanchez, MD 842 Therapeutic Joint Injections Brandt C. Wible, MD, A. Keith Rastogi, MD, and Julia R. Crim, MD