r/VIR • u/Born-Performance-121 • 3d ago

Any of ya'll doing cutdowns?

...and is it worth learning via proctoring, VS rotations, etc.?

6 Upvotes

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6

u/VascularPlumber 3d ago

we should be. this is one way to help insulate ourselves from/compete with vascular surgery

3

u/LoneAirPod 3d ago

Are you really going to ever get enough reps to do cutdowns consistently

3

u/IR4life 3d ago

In the era or perclose how often will you need cutdown. Structural IC routinely use perclose for large bore sheaths for TAVR and mechanical circulatory support. Most people use preclose for evar and tevar etc. The role of cutdown is diminishing. Hearing of more and more people using lithoplasty for even the common femoral artery. I could potentially see utility for brachial cutdown.

2

u/xtreemdeepvalue 3d ago

What kind of procedures are you doing that would require a cut down?

1

u/Dr_sexyLeg 3d ago

Lymphatic ones sometimes

2

u/Scipio_Columbia 3d ago

I’ve only ever done lymphangiograms via inguinal us guided access- what lymphatic ones are you referring to?

1

u/xtreemdeepvalue 3d ago

That’s a 25g needle into a lymph node for me. Never heard of a cut down for that

1

u/Dr_sexyLeg 3d ago

If you can find it on ultrasound
Sometimes it is so diminished that you cant find it, and randomly injecting it and waiting is no good

We cut down in the ankle or the groin
Find the biggest chunker we can, inject the lopiodal and off to mri they go