In all venous procedures we place a needle into a vein, usually in the groin or neck to gain access to the labyrinth of vessels to get anywhere in the body we need to get to the target for treatment. We use a variety of catheters and wires with various angles and tensions to allow us to guide around corners and access any vessel we want. Most procedures can be done under local anaesthetic or sedation which allows quick recovery.
Some men suffer with distended veins in the scrotum which causes swelling and pain. This procedure involves inserting a needle into the vein in the groin or neck, then guiding a catheter under x-ray guidance to the vein draining the scrotum. We then place metal coils or glue into the vein draining the scrotum which relieves the symptoms. We now also perform this procedure for some men with poor sperm function as there is an association with subfertility. Patients for this procedure are referred to us by our urology colleagues or the subfertility clinic. Patients are seen in an IR outpatient clinic prior to the procedure to ensure they understand the procedure and give informed consent. The below x-ray images show a catheter inside the veins and following deployment of coils in the testicular vein. This procedure is performed under local anaesthetic as a day case procedure which allows a very quick recovery.
Some patients need regular intravenous therapy such as chemotherapy or antibiotics or may require a line for dialysis. We insert a needle into a vein and guide a tube over a wire. We then bury the tube under the skin to prevent infection. They are often inserted into the veins in the neck and chest, but can be inserted into the veins in the groin. They are sometimes referred to as Hickman lines, Bard lines, dialysis lines or tunneled central lines. This procedure is usually performed under local anaesthetic and sometimes with sedation. Most are performed as a day case procedure which allows for a quick recovery.
Some patients have a surgically formed connection between an artery and vein in the arm to have dialysis if their kidneys have failed. Sometimes these fistulas develop a narrowing. We insert tiny balloons to open up the narrowings to keep the fistula working. The images below show a balloon being inflated in a narrowed segment in the upper arm, then the narrowing is gone. This procedure is performed under local anaesthetic as a day case procedure which allows a very quick recovery.
Some patients can develop a clot in an artery or a vein. We insert tubes to the affect vessel and slowly drip clot busting drug directly into the affected vessel to dissolve the clot and re-establish blood flow to the affected area. Patients for thrombolysis are usually referred to us by our vascular surgery colleagues and may prevent an open surgical declotting operation. Patients are admitted to the specialist vascular Enhanced Care Unit or General Critical Care for this procedure for close monitoring.
Sometimes when clot forms in an artery or a vein we can insert a tube and either suck out the clot using a vacuum or macerate the clot to break it up to help re-establish flow to the affected area. We often perform this procedure on fistulas which have clotted off but it can be performed in other vessels.
Patients with liver disease can develop dilated veins in the abdomen and around the oesophagus due to high pressure within these veins. These can rupture and lead to life-threatening bleeding. To prevent this, we insert a needle into a vein in the neck and guide a wire into the liver. We then form a communication between the liver and the heart to reduce the pressure in the veins and prevent the chance of catastrophic bleeding. The x-ray images below show how this is performed. Patients for this procedure are referred to us by our gastroenterology colleagues. This is a complex and challenging procedure and is one of very few procedures we perform under general anaesthesia. Patients are cared for on the gastroenterology ward after their procedure for close observation and monitoring.
In patients with DVT (clot in the legs) it’s sometimes necessary to put a filter in the main vein going back to the heart to prevent clot travelling to the lungs, which can be life-threatening. We insert these filters through the vein in the groin or the neck and remove them once the clot in the leg has dissolved. Removing the filter is like playing a game of “hook a duck” where we have to put a loop around a tiny 2mm hook inside the centre of the body, all performed from the neck whilst looking inside you with an x-ray camera. Patients for this procedure are referred to us by our medical and surgical colleagues. This procedure is performed under local anaesthetic and can be done as a day case procedure which allows for a quick recovery.
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IMPORTANT INFORMATION ON BLOOD TESTING DUE TO COVID-19
If you are experiencing symptoms associated with COVID-19, e.g. fever, loss of taste or continuous new cough, please DO NOT attend for a blood test.
Earlier this year, the Government revised the guidance on Shielding for CEV patients. All those who have been identified as CEV have been advised to follow the same guidance as everyone else, whilst potentially thinking about extra precautions you could take to reduce your chance of catching COVID-19.
Taking into account this guidance, and the evidence that most patients have now resumed having their blood tests at their usual preferred location, UHCW will no longer be providing the Shielding phlebotomy service from Monday 13 December 2021. You will need to make arrangements to get your blood tests done, as you did prior to the pandemic at locations across Coventry and Warwickshire at www.uhcw.nhs.uk/bloodtests If your specialist has requested a blood test which is due to be taken prior to Monday 13th December, you can expect it to take place at a ‘Pop-up’ clinic, as before. Any blood tests required after this date will need to be a booked appointment.
You can keep up to date with the latest advice from the Government and from UHCW on the following website: www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19
Click on the map for information about phlebotomy clinics in Coventry. You can book an appointment online at the locations in red.
Please book an appointment before attending for a blood test. Click on the ‘Book Online’ button above. Booking an appointment helps patients, their carers and family members to plan their hospital visit better, helping to reduce clinic waiting times and enabling patients to be seen much more quickly.
Location: Outpatients Department, on the ground floor. Opening hours: 8am-4.45pm, Monday to Friday (excluding bank holidays).
Children under 16 years old will need to book online here.
Please book an appointment before attending for a blood test, click on the ‘Book Online’ button above. Patients from Rugby and the surrounding areas are able to access the Friends Blood Taking Unit at the Hospital of St Cross.
Referrals for blood tests can be from GP's, practice nurses or from hospital consultants. Patients are also able to leave other samples, such as urine, which have been collected at home, at the hospital's Pathology Reception.
Location: Near Brookfield House, just off North Road - map here. Opening hours: The blood taking clinic sessions for adults and children are listed below:
Monday -Friday 7am-4:45pm Appointment only
Wednesday Evening 5pm-7pm Suspended due to COVID
Saturday Morning 7am-10pm Suspended due to COVID
April 2020 NEW - This Clinic is now by appointment. Please book an appointment before attending for a blood test. Click on the ‘Book Online’ button above.
Address: Stoney Stanton Road, Coventry CV1 4FS Location: Access is via the main doors, the Phlebotomy team are in Area A. Opening hours: Monday to Friday (excluding bank holidays). 8am–4.45pm
Glucose Tolerance Test (GTT)
Specialist Tests - There are a small number of specialist tests where blood needs to be taken on a hospital site as the sample must be transferred to the laboratory rapidly for the test to be undertaken. Click here for a list of these specialist tests and to find out more.