Image-guided interventional techniques have markedly altered the manag
ement of many cardiothoracic problems in the intensive care unit. Thes
e techniques are less invasive, more patient friendly, and cost-effect
ive. This article covers venous line placement and management, transpl
eural and transpulmonary biopsy and drainage procedures and interventi
ons for variceal bleeding, hemoptysis, massive pulmonary embolism, and
veno-occlusive disease.