Interventional Radiology

Overview

Interventional Radiology (I.R) is at the cutting edge of modern medicine and has brought significant improvements in patient care. Radiology is developing and deploying a unique and novel combination of imaging, therapeutic and navigation technologies which together make up the Multimodality Interventional Radiology.

All procedures are done through single needle puncture, No cut, No suture.

For FNAC, Biopsy, angiography, stenting, embolization, laser ablation, radiofrequency / microwave ablation procedures.

Diseases Treated using Interventional Radiology

1) Cancer Treatment

Bring back ur Smiles

CANCER is now treatable only through a small needle puncture.

No Surgery, No Chemo, No Radiation

Interventions in Cancer

• From the diagnosis of cancer to its treatment INTERVENTIONAL RADIOLOGY offers better options, which are minimally invasive and equally effective as surgery/ chemo/ radiation.
• FNAC / BIOPSY – to determine its cancer we have to take a sample from the tumor for examination.
• Treatment of these cancers can be done through Interventional Radiology( liver, lung, kidney, breast cancer, thyroid, and bone cancer ).
• Radio Frequency Ablation/ Microwave ablation – Killing the cancer cells by burning them up through a small puncture. liver, Kidney, breast, lung, thyroid cancer & bone cancers can be treated by Burning them off.
• Selective chemoembolization of liver cancer –
• Transarterial bland embolization/ Transarterial chemoembolization – cutting the blood supply of cancer cells along with depositing of chemo drug directly into the tumor – kills them. Rest of normal liver and entire body will not be affected by toxic effects of chemo drug.
• DC bead transarterial chemoembolization -cutting the blood supply, using special spherical particles which also deliver the drug into the brain tumor.
• Transarterial radioembolization- delivering radiation directly into a tumor, without causing any harm to normal liver and rest of the body.
• All procedures are done only through small, single needle puncture, no cut, no suture, no scar.

2) Brain Tumor

Stroke is the third leading cause of death, after cardiovascular disease and cancer.  Strokes disable more adults than any other condition.  When a stroke occurs, a blood vessel in the brain becomes blocked or bursts, sometimes causing permanent brain damage or even death. However, prompt treatment and follow-up care may protect brain cells and help patients lead healthy, productive lives. There are several symptoms particular to stroke. Any of these symptoms should Consult a doctorimmediately:

• Drooping on one side of the face, especially when the person tries to smile.
• Pronounced weakness on one side of the body.
• When the person lifts both arms, one arm seems to drift down.
• Slurred speech.
• Some people experience a sharp, jabbing headache, but not everyone does.

Two types of strokes

Ischemic Stroke

Accounts for approximately 80 to 85 percent of all strokes. the blood supply to a part of the brain becomes blocked.  This prevents oxygen and nutrients from reaching brain cells. Within a few minutes, these cells may begin to die. 

Ischemic stroke is a life-threatening condition. We, neuro-interventional radiology physicians may be able to navigate a catheter to the site of the blockage in the blood vessel, to remove the blockade to restore the flow to the brain causing minimal damage to the brain.

A clot can be removed by –

• Delivering clot-dissolving medicine into the clot.
• Mechanical thrombectomy – removing clot by a mechanical device.

These treatments should be performed as soon as possible after the onset of the stroke.  The sooner treatment is started, the better the outcome.

Hemorrhagic Stroke

During a hemorrhagic stroke, a blood vessel within the brain leaks or ruptures, and bleeds into the brain tissue (intracerebral hemorrhage) or into the surrounding space (subarachnoid hemorrhage).  This can exert pressure on the brain and cause the neurological deficit. Neuro-interventional radiologists will perform an angiogram with the goal of identifying the cause of the bleeding, and, if possible, stop the source of bleeding by a technique called embolization.

Brain Aneurysm and  its rupture causing Subarachnoid Hemorrhage (SAH)

Sudden onset of a severe headache without warning is seen in SAH. An aneurysm is a weakened area in a blood vessel that may enlarge and rupture.  Approximately eight to ten percent of all strokes are caused by ruptured brain aneurysms.  Aneurysms can be treated by endovascular techniques, including insertion of platinum coils into the aneurysm or placement of flow-diverting stents to stop blood flow to the aneurysm.  These methods may help prevent rupture or re-rupture of the aneurysm.

Time is brain – Speed is the key to effective stroke treatment – the faster doctors can restore blood flow to the brain, the better their chances of preventing brain damage.

Be and act fast to visit Best Neurologist in India to save your dear ones from permanent damage of the brain.

3) A V Fistula

Preserving Your Dialysis Lifeline

Sign of a falling Fistula

• If there is bleeding from Av fistula
• If there are any signs of infection, or any changes in appearance to the skin, such as swelling, red skin, pus or if the skin around the Av fistula is warm to the touch.
• If there is bulging over the Av fistula or in your hand.
• If you have a fever of above 100.5F (38C), or chills.
• If pulse in your Av fistula is slower than normal, or if you cannot feel a pulse.
• If your hands or legs are numb, cold to the touch or weak.
• If there is swelling to your arm, leg, face or neck.
• If enlarged veins appear on upper arm or chest.
• If there is an increase in venous pressure during dialysis or a decrease in blood flowing through Av fistula.
• If there is prolonged bleeding after removal of dialysis needles.

4) SEVERE LEG PAIN – Peripheral Arterial Disease (PAD)

Peripheral Arterial Disease is a disease in which plaque builds up in the arteries that carry blood to your head, organs, and limbs. Plaque is made up of fat, cholesterol, calcium, fibrous tissue, and other substances in the blood.

When plaque builds up in the body’s arteries, the condition is called atherosclerosis. Over time, plaque can harden and narrow the arteries. This limits the flow of oxygen-rich blood to your organs and other parts of your body.

P.A.D. usually affects the arteries in the legs, but it also can affect the arteries that carry blood from your heart to your head, arms, kidneys, and stomach. This article focuses on P.A.D. that affects blood flow to the legs.

Symptoms of PAD

Common symptoms of PAD include the following:

• Aching or burning sensation in the muscles (not the joints) of your legs or arms, such as when walking up a hill or doing repetitive arm exercises, The sensation stops after you’ve taken a short break.
• Legs feel tired or heavy.
• Discoloration of, or numbness in, the legs or feet.
• Sores on the toes, feet or legs that won’t heal.

People with PAD sometimes have other symptoms, too:

• Slowed walking pace
• Changes in your walk, such as a limp
• Pain while resting
• Pain in feet or toes that hurts more when they are elevated
• Change in color, especially redness of the skin on your legs
• Burning or aching feet
• Numbness in the legs
• One leg or foot feels cooler than the other
• Loss of hair below a certain point on the legs
• Color is slow to return after pressing down on your leg with your thumb

PAD Without Pain

at least half the people who have PAD do not have any symptoms or fail to recognize their symptoms as PAD. Too often, people think the pain they feel is part of the aging process and they don’t get help as early as they should. 

That’s why it’s so important to see your doctor regularly and ask about PAD.

DIAGNOSIS CAN BE DONE THROUGH SUBJECTING PATIENT SUFFERING FROM ABOVE SYMPTOMS TO A DOPPLER ARTERIAL STUDY OR CT ANGIO.

Treatment

Angioplasty and Stenting

When arteries become narrowed or blocked, the circulation of blood around your body is reduced. This can cause symptoms such as muscle pain, dizziness and tissue damage as the affected regions are deprived of blood and oxygen.

Angioplasty or stenting is a procedure used to treat the narrowing or blockage of an artery. This uses either a balloon to stretch the artery (angioplasty) or metal scaffold to hold the artery open (stent). These procedures improve blood flow which helps to relieve any symptoms you are experiencing.

Atherectomy, in which the plaque is scraped off of the inside of the vessel wall (albeit with no better results than angioplasty).

All these procedures are done without cut, suture or scar through a small pinhole puncture.

5) Benign Prostate Hypertrophy (BPH)

The prostate is a walnut-sized gland located between the bladder and the penis . The  gland surrounds the urethra, the duct that serves for the passage of both urine and semen.

Normally, the prostate reaches its mature size at puberty, between ages 10 and 14. It usually starts to enlarge after 40 years of age. The prostate grows larger due to an increase in the number of cells (hyperplasia) reason being unknown. About half of men aged 51-60yrs and up to 90% of men over the age of 80yrs will develop an enlarged prostate. “All men will develop BPH if they live long enough,” 

When it grows beyond the normal size, it would start causing lower urinary tract symptoms by obstructing the urinary tract. BPH leads to both a decline in urinary-associated and overall quality of life.

Symptoms

• Increased frequency of urination
• Frequent urination at night
• Frequent urination that often produces only a small amount of urine
• Hesitant or interrupted urine stream
• Leaking or dribbling urine
• Sudden and urgent need to urinate
• Weak urine stream
• Feeling like the bladder is not completely empty after urinating
• Occasional pain when urinating
• Having to rush to the bathroom suddenly after the urge to urinate
• Sometimes complete obstruction when severe

Lifestyle Changes to Relieve BPH Symptoms

• Avoid alcohol and caffeine
• Avoid drinking fluids at bedtime, and drinking smaller amounts throughout the day
• Avoid taking decongestant and antihistamine medications
• Get regular exercise
• Make a habit of going to the bathroom when you have the urge
• Practice double voiding (empty the bladder, wait a moment, then try again)
• Practice stress management and relaxation techniques

The symptoms of BPH may mimic symptoms of other conditions, including cancer and infections.

Diagnosis And Treatment

A simple ultrasound examination can differentiate and detect benign prostate hypertrophy. Ultrasound is safe, noninvasive, and does not use ionizing radiation.  It’s also used to investigate a prostate infection nodule being benign/cancer.

Once diagnosed, Gold standard treatment for benign prostate hyperplasia is transurethral resection of the prostate (TURP) or open prostatectomy (OP). Recently, there has been increased interest and research in less invasive alternative treatments with less morbidity procedure by name prostate artery embolization (PAE). PAE is an effective alternative to surgery.

Prostate artery embolization, a minimally invasive treatment, is known to offer symptom relief to men with benign prostatic hyperplasia (BPH), or an enlarged prostate gland. When a man has BPH, his prostate gland grows larger. For this to happen, the prostate needs a steady supply of blood. During PAE, a small puncture is made in the groin and a catheter inserted into the groin. Using image guidance, the catheter is directed to the blood vessels on both sides of the enlarged prostate gland. Microscopic beads are used to block blood flow to specific areas of the robotic prostate surgery, shrinking the gland and alleviating urinary problems. With the help of cone beam CT, successful delivery of microbeads to the target vessels is ensured and the non-target embolization can be avoided. The procedure is performed by a specialist called an Interventional Radiologist.

These patients experienced an 84% cumulative success rate in the first six months, and 76.2% thereafter.

With no cut, no suture, no scar techniques Interventional Radiology always offers the patient a better alternative to surgery resulting in the same efficacy. Compared to surgery IR procedures requires less hospital stay (maximum just an overnight), results in faster recovery and has fewer chances of infection. You would be wise enough to choose the best treatment option available.

6) Uterine Fibroid

“GET RID OF FIBROID, NOT UTERUS”. BRING YOUR SMILES BACK…

Uterine Fibroid it is one of the most common benign tumors and condition are seen in many females.

Signs and Symptoms of Uterine fibroid

• Abdominal pain
• Heavy menstrual bleeding
• Prolonged menstrual periods
• Frequent urination
• Backache
• Pelvic Pain
• Constipation
• Infertility
• Medical abortion
• Distended lower abdomen

Treatment

Traditional treatments were hysterectomy– patient uterus will be removed Myomectomy open / lap – a part of the uterus is scraped off – can cause adhesions. Any disturbance in normal anatomy will cause complications later.

Best will be UTERINE ARTERY EMBOLIZATION – done through a small pinhole. With very less or no complications.

Advantages of Uterine Artery Embolization procedure

• Non- surgical / No General Anaesthesia
• A very safe / Single puncture procedure
• No cut/No suture / No Scar technique
• Shorter recovery / Less Hospital stay /Fewer chances of infection
• Can retain uterus
• Does not affect fertility / Can conceive even after the procedure

7) Varicose Veins

It’s not just a cosmetic concern Varicose Veins is a Progressive and Irreversible Disease.

About 30% of the Indian population is suffering from varicose veins. Know if you are one of them.

Signs & Symptoms

• The appearance of spider veins in the affected leg.
• Ankle swelling.
• Aching, heavy legs (often worse at night and after exercise).
• Bumpy, swollen twisted veins raising over the skin surface of legs.
• A brownish-blue shiny skin discoloration near the affected veins.
• Redness, dryness, and itchiness of areas of skin.
• Cramps Minor injuries to the area may bleed more than normal and/or take a long time to heal.
• Non-healing venous ulcers over legs mostly on ankles.
• Chronic venous insufficiency.

Treatment

• Endovenous Laser Treatment + Foam Sclero Therapy

ALL PROCEDURES ARE DONE THROUGH SINGLE NEEDLE PUNCTURE, NO CUT, NO SUTURE