20171025 Pelvic congestion syndrome / GI bleeding suspected aneurysm / methylene blue for localization

• Pelvic congestion syndrome 
• Right femoral vein puncture, C1 for left 
• Renal vein, ovarian vein, test for flow direction, if flow into pelvis or stasis, PCS is diagnosed
• Coil embolization until proximal ovarian vein
• SIM2 for bilateral internal iliac vein?
• SIM1 for ipsilateral ovarian vein?
• Total 38 coils used 
• GI bleeding suspected aneurysm
• 10 cc Lipiodol
• 3cc or 5cc D5W
• 1cc x2 
• 0.25 cc glue + 0.75 Lipiodol = 25% NBCA
• 如果一直wire進spleen 可以考慮試試看把catheter進spleen再慢慢拉回來，看管子會不會彈進去，不過吳失敗了
• 用mosquito凹.35 wire，夾住TIP捲捲捲，小心wire不要凹太兇怕會斷掉
• Methylene blue for localization
• 藥可能打太多? 整片lobe都是藥
• 一開始做的時候先打一點點blue，之後放coil，最後拉到聖0.5公分的時候再補一點點blue
• 從側面進去記得確認rib 位置，不要進錯肋間，今天的case差了3.5公分