Interventional Radiology

What is Interventional radiology (IR)?

Interventional radiology is one of the most recently introduced and rapidly evolving department worldwide that uses minimally invasive image guided techniques (like Digital Subtraction Angiography, CT, MRI and USG) to treat many ailments of most of the human body through a small pin hole like opening in the groin or hand. All though IR is less well known amoing by General Physician it is called specialist’s specialist. It is at the forefront of medical technology and innovation. The range of diseases which can be treated in an IR department are extensive and are constantly evolving. It includes, but are not limited to, angiography, angioplasty / stenting in neurovascular, pulmonary, aortic, peripheral vascular (arterial and venous), oncological, gastrointestinal and genitourinary disease. Many major procedures done in an IR department has improved the outcomes in many complex ailments which were previously considered untreatable . Advantages of interventional radiology procedures are its minimal invasiveness and hence reduced morbidity and rapid recovery. IR procedures can also be used as an adjuvant to surgery and combined procedures with surgeons can optimise patient care.

What all we can treat?

Virtually all body parts and systems can be treated using IR techniques. However, broad categories of treatments available include opening up of blocked tubes (arteries, veins, bile ducts, ureters, fallopian tubes etc); Stopping bleeding from any cause (gastrointestinal bleeding, obstetric and gynaecological bleeding, traumatic bleeding, bleeding after surgery, brain aneurysms, vascular malformations) by occluding the vessels with embolisation; Destroying tumours in the uterus, liver, lung, kidney by delivering local chemotherapy, embolisation or ablation techniques (such as cryotherapy and radiofrequency ablation); Minimally invasive treatments of thoracic and abdominal aneurysms; Preoperative embolisation to improve the safety of surgery.

Our department at Moulana hospital is the first in Malappuram district which can perform all neurovascular, peripheral vascular interventions and oncology related interventions. Some of the procedures which we can perform are as mentioned below:

 NEUROLOGY:

• Acute stroke – mechanical thrombectomy.
• Sub arachnoid hemorrhage – (bleeding in brain) due to ruptured blood vessels – aneurysm coiling and flow diverter placement.
• Arterio venous malformations – Embolization using DMSO/GLUE.
• Pre operative embolisations of tumours.
• Carotid and intracranial arterial angioplasty / stenting.
• Dural Arterio venous fistula embolisation.
• Carotico cavernous fistula embolisation.
• Spinal dural AV fistula Embolosation.

AORTIC AND PERIPHERAL INTERVENTIONS:

AORTA

Aortic stent grafting for ruptured and unruptured thoracic and abdominal aortic anuerysms

Stent grafting in aortic dissections.

ARTERIAL INTERVENTIONS

• Critical limb iscehmia – angioplasty and stenting of the affected vessels (iliac, femoro – popliteal and below knee arteries).
• Acute limb ischemia – thrombolysis. (catheter directed intra arterial).
• Embolisation of AVM.
• Embolisation of pseudoaneurysms.

VENOUS INTERVENTIONS

• Deep vein thrombosis – IVC filter placement and pharmaco mechanical thrombectomy and stenting of veins.
• May thurner syndrome – angioplasty and stenting of iliac veins.
• Ablation of Varicose veins
• Central vein angioplasty and stenting.

PULMONARY

• Hemoptysis – bronchial artery embolizations.
• Pulmonary AVM and Rasmussen’s artery embolisations

GASTROENTEROLOGY

LIVER TUMOUR

• Trans arterial chemo embolisation of liver tumour (TACE).
• Ablations of liver tumours (Radio Frequency Ablation / RFA, Microwave Ablation)
• PTBD (biliary drainage) and stenting
• Portal vein embolisation

CHRONIC LIVER DISEASE

• TIPSS (trans jugular intraheaptic porto sysytemic shunt), DIPPS (Direct intraheptic porto- systemic shunt)
• Trans jugular liver biopsy.
• Hepatic vein stenting
• Portal Vein embolisation
• Bleeding gastric varices embolisation – BARTO, PARTO, CARTO

MESENTERIC:

• Chronic Mesentric Ischemia – celiac artery / mesentric artery angioplasty and stenting.
• Post trauma pseuoaneurysm / bleeder embolization
• Visceral arterial aneurysm / psudoaneurysm embolizations

NEPHROLOGY / UROLOGY:

• Renal AV fistula and pseudoaneurysm embolisation
• Renal tumour embolization , ablations.
• AV fistuloplasty
• Central vein stenosis – angioplasty and stenting
• Permcath placement – chronic tunneled hemodialysis catheter placement.
• Percutaneous nephrostomy (PCN) placement.
• Antegrade urteric stenting

GENITOURINARY:

• Uterine fibroid embolisation
• Uterine AVM embolisation
• Pelvic congestion syndrome
• Fallopian tube recanalisation.
• Prostatic artery embolisation for BPH (benign prostatic hypertrophy)

ENT

• Pre operative embolisation of vascular tumours.
• Epistaxis – embolisation of internal maxillary artery.

OPHTHALMOLOGY

• Carotico cavernous fistula embolisation.
• Intra arterial Chemoinfusion for retinoblastoma.
• Orthopedic.
• Spinal tumour / hemangioma preoperative embolisation
• Post trauma pseudoaneurysm embolization