INTERVENTIONAL RADIOLOGY

WHAT IS IR ? 

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INTERVENTIONAL RADIOLOGISTS

use imaging, like X-rays, to see inside a patient’s body, pinpoint where the problem is and map out how to get there without a surgical operation. These highly skilled physicians use a very small nick in the skin to guide catheters or other instruments through the vascular system, urinary tract, or gastrointestinal tract, in a minimally invasive manner to treat disease directly at the source, or to take tissue samples for analysis.

WHAT ARE THE ADVANTAGES OF IR PROCEDURES?

While no treatment is risk free, the risks of IR procedures can be far lower than the risks of open surgery. The specific advantages are:

  • No large incisions; usually performed through a small nick the size of the lead tip of a pencil.
  • Since there is no open surgery, there are no large scars following the procedures.
  • Minimally invasive procedures have a lower risk of complications than open surgical procedures.
  • Many procedures can be performed on an outpatient basis or via short hospital stay.
  • Patients rarely require general anaesthesia; typically sedation and pain medication are given to make the patient comfortable during the IR procedure.
  • Recovery time is often significantly reduced.

PERIPHERAL ARTERIAL DISEASE AND DIABETIC FOOT

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Arteries in the leg supply oxygen to the tissues in the foot and legs. Blockage of arteries is commonly seen in Diabetes and/or with Smoking.
Lack of blood supply leads to pain in legs while walking. As blockages worsens with time, eventually even a small injury to foot, then leads to ulcer and gangrene.

Color Doppler / Ultrasonography, CT / MR Angiography help in detecting these blockages. However angiography (DSA) helps to plan the treatment.

These blocked arteries are balloon dilated and stents are placed to improve blood flow and supply of oxygen to help reach the wound and prevent amputation.
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Interventional Radiologists are trained to perform angioplasty and stenting of small arteries of the lower limb.

“Treating patients with diabetic foot at the earliest prevents major amputation.”

HEPATOCELLULAR CARCINOMA AND LIVER TUMOURS

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Patients with –

  • Cirrhosis of liver
  • Hepatitis B and C
  • Fatty liver
  • Cancer of Intestine

Are at high risk of developing cancers of the liver.

Often patients have minimal general symptoms and hence tumours are detected late. Regular blood tests, ultrasonography, CT and MRI would detect these malignant tumours.

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Interventional Radiologists are a part of team, treating these tumours. Various procedures that can help control the growth of the tumour are:

Radio Frequency Ablation (RFA)
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Trans Arterial Chemo Embolization (TACE)

Trans Arterial Radio Embolization (TARE using Yttrium-90)

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ANEURYSM OF AORTA

Aorta is the main blood vessel supplying oxygenated blood to the body. Weakening of the wall of the aorta leads to enlargement of the lumen. This ballooning of the aorta is known as Aneurysm. Because of high pressure of the blood within the aorta, the aneurysm can rupture and pose a major danger to life.

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Thoracic Aortic aneurysm

Early detection and treatment is advised. Ultrasonography and CT scan help in detecting the aneurysm.

Endovascular stent graft is a minimally invasive interventional procedure and it’s a good option. The procedure is well accepted and tolerated by most of the patients.

VARICOSE VEINS AND DEEP VEIN THROMBOSIS

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Veins in the leg carry impure blood back to the heart. Two sets of veins are present in the legs. (A) Deep veins located within the muscles and (B) Superficial veins located below the skin. Valves in the vein direct the blood to travel towards the heart.

When superficial veins become dilated and tortuous and look like ugly bluish coloured bunch of worms, it is called varicose veins. Varicose veins may be associated with pain, swelling, ulcer and bleeding.  Early diagnosis and treatment is recommended.

Minimally invasive Endo Venous Laser Ablation (EVLT) wherein via a needle puncture, a thin laser cable is introduce into the vein. The laser energy generates heat within the vein and this destroys the wall of the vein leading to its closure.

This is relatively risk free and often a day care procedure.

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Deep veins in the legs can get blocked with blood clots. Certain interventional procedures can help dissolve or suck out this clot and hence help re-open the blocked vein. If the patients presents late, then Balloon Angioplasty and Stenting can help restore the blood flow.

 

ASSISTANT PROFESSOR IN DEPT OF RADIO-DIAGNOSIS,

CONSULTANT  IN NEURORADIOLOGY & INTERVENTIONAL RADIOLOGIST (VIR)

Dr. Navin M Mulimani   MD (Radiodiagnosis), D.M. (Neuroradiology & Interventional Radiology)  has joined as Consultant &  Associate Professor in Department of   Radio-Diagnosis  at KLES Dr Prabhakar Kore Hospital & MRC.
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