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Saphenous Vein Ablation - ClariVein® Catheter
Proceedural Checklist
Physician: ________________________________________________ Date: ____ Facility: ___________________________________________________ Procedural Step
1. Review the preoperative clinical assessment (History and Physical Exam) and duplex 2. Confirm the vein to be treated, diameter, treatment lengths and venous access site.
3. Identify junctions to deep system (saphenofemoral junction (SFJ), saphenopopliteal 4. Ensure that all necessary instruments and fluids are available in the procedure room. 5. Confirm the operating room bed can move patient to the supine or prone position.
6. Determine the concentration, volume and infusion rate of sclerosant based on sclerosant type, vein to be treated, and diameter and length measurements. 7. Rotate leg for easy access (great saphenous vein (GSV) or prone (SSV)). 8. Prepare and drape leg in sterile manner for ultrasound use and access. 9. Use 1% lidocaine locally at access site. Open 4-5Fr Micro Puncture Kit (most desirable), other access device or 18g or larger, IV catheter. 10. Cannulate vein under ultrasound guidance with needle and wire.
11. Insert a 4-5Fr micro puncture sheath over a guide wire that can reach the junction (preferred to ensure the vessel is open). 12. Select proper length ClariVein® catheter (45 cm or 65cm). 13. Open the Cartridge Unit (Catheter) and pass it to the sterile field. 14. Assemble the Cartridge unit (Catheter).
a) Check Valve: tighten Check Valve onto the female Luer Injection Port on b) Stopcock: seat male adapter of the Stopcock into female Luer Injection Port on Cartridge unit (Catheter) then tighten luer lock collar.
15. If used, properly set the Stopcock for flushing.
16. Flush the Catheter and Check Valve or Stopcock with normal saline.
Angiocare Australia & New Zealand Pty Ltd
PO Box 1089, GAILES QLD 4300
Ph: +61 1300359879 Fax: +61 7 3800 5989
Email: info@angiocare.com.au
17. If used, properly set the Stopcock to shut off flow to the patient.
18. Advance Catheter through sheath under ultrasound guidance.
19. Steer by turning the Cartridge; do not attempt to twist or turn the Catheter (wire).
20. Position the Catheter tip 2 cm to SFJ for GSV or at the fascial curve for small 21. Open the Handle Unit (Motor Drive) and pass it to the sterile field. 22. Depress trigger and note green LED light. Discard if Green LED light does light.
23. Assemble the Handle Unit (Motor Drive) on to the Cartridge Unit (Catheter) (1st position click-wire tip is sheathed, 2nd position click-angled part of wire tip is 24. Position the unsheathed wire dispersion ball 2 cm to SFJ for GSV ablation or at the fascial curve for SSV ablation under ultrasound. Measure the distance, do not 26. Inform the patient they will feel a slight vibration in the groin area.
27. For vein or vein sections greater then 10 mm in diameter, apply slight manual compression. Back off if the patient feels pain.
28. Keep the Catheter straight at all times.
29. Perform mechanical ablation for first 2 sec/ 3mm (any wire rotation must be 30. Start chemical infusion and mechanochemical ablation; pull down at approximately 1.5mm/sec (6 -7 second count between cm markings). Sclerosant infusion rate depends the vein treated, sclerosant type, vein diameter and length.
31. With 15-20 cm of treatment length remaining, move the access sheath to the most proximal position on the Catheter. Do not rotate the tip in the access sheath.
32. Complete the procedure without a sheath.
33. Continue treatment until the white mark on the catheter is visualized (approximately 8 cm from the ball tip); treat an additional 2-3 cm. Treatment length beyond the white mark depends on the skin-to-vein depth of the patient being treated. Extravascular treatment will cause pain and is to be avoided.
34. Release the trigger to stop the device, re-sheath the wire tip (push the Cartridge Grip/Guide Wing to position one) and remove the device.
35. Document the patency of deep venous system with Duplex ultrasound. 36. Document there is no thrombus extending into common femoral vein/popliteal vein 37. With color Duplex ultrasound document that the treated vein has no flow.
Angiocare Australia & New Zealand Pty Ltd
PO Box 1089, GAILES QLD 4300
Ph: +61 1300359879 Fax: +61 7 3800 5989
Email: info@angiocare.com.au
38. Apply simple dressing over access site. 39. Ask the patient to perform several plantar flexion movements of foot or the physician or nurse should flex the foot.
40. Apply appropriate type of compression stocking. 41. Advise the patient of the need for ambulation, continued compression for 24 to 48 hours, intermittent compression during day for 2 weeks, with immediate resumption 42. Perform appropriate clinical follow-up Angiocare Australia & New Zealand Pty Ltd
PO Box 1089, GAILES QLD 4300
Ph: +61 1300359879 Fax: +61 7 3800 5989
Email: info@angiocare.com.au

Source: http://www.clarivein.com.au/wp-content/uploads/2011/03/Clarivein-Procuderal-Checklist1.pdf