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Interventional Radiology
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Consent Forms
Please feel free to print out and read the consent
form for your procedure. You do not have to bring these
forms with you to your appointment; we will have copies
for you to sign when you arrive.
Each consent form explains the procedure, its risks,
and alternatives.
Adrenal Venography and Adrenal Vein Blood Sampling
Arteriography and Possible Angioplasty, Stent Placement or Lytic Therapy
Biliary Tube Check, Change And Possible Stricture Dilation, Stent Placement Or Stone Removal
Chemoembolization of the Liver
Creation of a Transjugular Intrahepatic Portosystemic Shunt (TIPS)
Dialysis Fistulogram and Possible Angioplasty, Stent Placement or Thrombolytic Therapy
Drainage Tube Check, Change and/or Possible Removal
Inferior Vena Cava (IVC) Filter Placement
Interventional Radiology Procedure (General)
Diagnostic and/or Therapeutic Paracentesis
Nephrostomy Tube Check, Change and Possible Stricture Dilation, Stent Placement or Stone Removal
Percutaneous Biliary Drainage and Possible Stricture Dilation, Stent Placement or Stone Removal
Percutaneous Feeding Tube Placement (Gastrostomy, Gastrojejunostomy, Jejunostomy)
Percutaneous Feeding Tube Check and/or Change (Gastrostomy, Gastrojejunostomy, Jejunostomy)
Percutaneous Fluid Collection/Abscess Drainage
Peripherally Inserted Central Catheter
Percutaneous Nephrostomy And Possible Stricture Dilation, Stent Placement Or Stone Removal
Percutaneous Transcisternal Catheterization of the Thoracic Duct for Diagnosis and Embolization
Port Removal
Pulmonary Arteriogram And Embolization
Pulmonary Arteriogram and Possible Lytic Therapy, Thrombectomy or Stent Placement
Transjugular Liver Biopsy
Uterine Artery Embolization
Vascular Embolization
Venography and Possible Angioplasty, Stent Placement or Lytic Therapy
Venous Access Device Placement (Port, Tunneled or Nontunneled Catheter)
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