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1、ModernHospitalGuangzhouInformedConsentofSuperior/InferiorVenaCaveBalloonDilatation(+StentImplantation)Patientname:Sex:Age:CaseNo:BriefdescriptionofdiseaseandtreatmentrecommendationsIamawarethatIhavebeendiagnosedwithandrecommendedtoundergounderanesthesia.Superior/Inferiorvenac
2、avestenosisorocclusioncouldleadtovenousreturnobstacle.Superiorvenacavelesioncouldleadtoheadandneckswelling.Inferiorvenacavecouldleadtohepaticcongestion,portalhypertensionandreturnobstacleofveinsoflowerextremityetc.Mainsymptomsareabdominaldistension,ascites,edemaofbothlowerext
3、remitiesandvenousulceretc.OtherPotentialrisksandhandling:Ihavebeeninformedthatthisprocedurecarriespotentialrisks.However,certainuncommonrisksarenotincludedhereinto.Themethodofsurgeryshouldbeindividualizedbasedonmedicalcondition.IhavebeeninformedthatIamentitledtodiscusswithmyp
4、hysicianregardingthesurgeryandanyassociatedspecialquestions.1.Iunderstandthatallanestheticprocedurescarrypotentialrisks.2.Iunderstandthatalldrugsmightcauseunwantedsideeffects,includingmildsymptomssuchasnauseaandrashes,seriousanaphylacticshock,andevenlife-threateningevents.3.I
5、understandtherisksassociatedwiththisprocedureandcorrespondingmeasurestaken:Commonrisksforinterventionaldiagnosisandtreatment1)Anestheticaccident;Cardiovascularandcerebrovascularaccidents(myocardialinfarction,cerebralinfarction,cerebralhemorrhageetc.);arrhythmiacouldbelife-thr
6、eatening.2)Variousinfectionsduringperioperativeperiod,includingpuncturewoundinfection,implantedstentinfection,lunginfection,urinarysysteminfectionetc.;3)X-ray-relateddamages;4)Hemorrhage,localhematomaofpuncturesite,falseaneurysm,angiorrhexisofvascularapproachoroperationtarget
7、;thoracicorceliachemorrhageorposteriorperitoneumhemorrhage;intervention-relateddamagesleadtovisceralhemorrhage(forexamplealimentarytracthemorrhageorurinarytracthemorrhageandintracranialhemorrhageetc.);severecasescanbeaddressedinashockevendeath;5)Damage:Puncturecouldleadtoarte
8、riovenousfistula;peripheralnerveinjurycausesnerveirritationsymptoms,