Interventional Radiology

Thanks to technological advancements, interventional radiology procedures are a boon. Various kinds of engineering are used in the medical field of interventional radiography for imaging the internal parts of a human body. Some of the techniques are mentioned below. 

Embolization: 

This is a catheter-based technique that uses coils, particles or glue to block tumour vessels or acute bleeding. 

When a tumour grows in our body, it requires a constant blood flow. The blood keeps the tumour alive. In case the blood supply stops, the tumour does not get any nourishment and slowly dies. 

Embolization is a unique technique that allows interventional radiation specialists to effectively target and eliminate the infection. The radiologist tries to cut the source of blood carefully so that the tumour is unable to grow any further. In the process of embolization, there is a minimum amount of interference to the other organs or blood vessels. 

Embolization requires a massive amount of liquid along with minute particles flushed into the body. This blocks blood flow in a particular area as the minute particles gradually stop the source of nourishment for the tumour. Embolization is beneficial for patients suffering from a tumour in their lungs, liver, kidneys, or bones. 

There are different procedures in which embolization can be done by interventional radiation. Before starting the process, the interventional radiologist gives local anaesthesia to the patient. As the procedure may take more than an hour, anaesthesia is given to ensure the patient doesn’t move and an accurate diagnosis of the tumour can be obtained. 

Moving ahead, the radiologist punctures the thighs of the patient with a minute needle to advance catheters and guidewires, a threadlike cluster of plastic tubes, in the arteries of the patient. After this, a contrast medium dye is injected into the catheter to get a clear view of the imaging. 

Once a clear view is obtained, the interventional radiologist will use a microcatheter to carefully inject embolic particles. The particles injected are usually 0.5 mm in size and contain a considerable dose of chemotherapy or yttrium radiation to cut off the blood flow to the tumour. 

There are side effects noted among patients who underwent this process, such as nausea or pain. However, consuming a medically approved painkiller shall provide some relief. 

Chemoembolization: 

Chemoembolization is very much like embolization, but uses local targeted high-dose chemotherapy to treat tumours. 

Chemoembolization is another reformed process of embolization. In the process of chemoembolization, the interventional radiologist places a minute-catheter in the blood vessel and injects it into the arteries. These arteries supply blood to the liver. 

The process of chemoembolization is like that of a cardiac angiogram. Drugs used for chemotherapy are injected into the catheter along with blood vessels, which restricts the area where a tumour in which the tumour spreads. The entire process involves injecting a highly effective anti-tumoral drug in the infected regions that are fighting the tumour from within. Double attack on the tumour shall stop the spread of it. 

Various kinds of tumour-like hepatoma or primary liver cancer metastasise and spread to the liver from colon cancer, carcinoid, ocular melanoma, sarcomas or any other type of tumour in another part of the body. 

Ablation:

Ablation is a needle or catheter-based technique that uses thermal energy forms, such as radiofrequency, microwave or cryo technique, to treat tumours or varicose veins. 

It is also popularly known as catheter ablation. In this procedure, either heat or extreme cold is applied to the infected area. Heat radiation is known as radiofrequency ablation, while freezing radiation is called cryoablation. 

The treatment has dire effects on the body, like abnormal braking circuits in the heart. It sometimes also destroys areas near the heart muscles, triggering symptoms of arrhythmias. 

The process of ablation is like that of the interventional radiology procedures of electrophysiology (EP) study, which is done to detect abnormal heart rhythms. The ablation process is beneficial for patients who have been detected with the abnormalities early. The entire process requires 8-10 weeks. 

Balloons and Stents: 

There are various techniques to open a blocked tube, such as an artery, vein, bile duct, ureter, colon, or oesophagus. 

Balloon Angioplasty and Stents is another unique interventional radiology procedure in which a long catheter with a balloon at the end is used to remove the plaque from the affected area. This IR procedure is performed in the cardiac catheterization laboratory, also known as Cath lab. Balloons and stents are the best tools used in the treatment of coronary artery disease (CAD). Usually, CAD cannot be managed by medicines. Therefore, the balloon and stent technique work best for CAD. 

The process involves a twist in traditional angioplasty. A long tube or catheter is designed with balloon-shaped tips. The balloons are inflated at the blockage site in the artery. This way, the plaque gets flattened, or even compressed, against the walls of the artery. This kind of angioplasty is also known as percutaneous transluminal coronary angioplasty (PTCA). 

Balloon angioplasty is quite beneficial as it can be used to open the vessels, which have become narrow or have shrunk down in many parts of the human body. The stent is a minute mesh-like device used in modern interventional radiology. It is made up of substances with metallic nature. The stent acts as a support or scaffold in the interventional radiology procedures. 

Usually, the stent is placed inside the coronary artery, which helps keep the blood vessel open. In this way, the stents help to improve the blood flow to the muscles of the heart, which eventually reduces the pain of angina. 

Stents are usually built with balloon-like fixtures at the end of the tube or catheter. These kinds of angioplasty are found in more than 80% of patients who get balloon angioplasty. Doctors use stents like this for body parts other than the heart as well. Stents can also be used in medical procedures involving carotid arteries in the neck or the arteries in the aorta, along with the peripheral arteries in the legs. 

Doctors usually suggest their patients to avoid drinking or eating after midnight prior to the day these tests are conducted. Patients who have diabetes must consult the doctor before undergoing the procedure, as it can impact blood pressure. During the procedure, the doctor attaches a catheter that goes into the artery inside the heart. A video monitor is used to see inside the body. Once the doctor has detected the blocked area, a dye is injected. This helps the doctor to get a snapshot of the coronary arteries. This method is also known as a coronary angiogram. 

Once the blocked area is detected, the doctor ties a thread, also known as guidewire, around the artery. After that, the balloon tip is inflated in that area, which subsequently presses against the plaque, causing compression against the artery walls. The inflation and deflation of the balloon are done several times to compress the affected area. The stent also contains medicine, which avoids further spreading of the plaque. 

Needle Biopsy and Drainage: 

Core biopsy is used for pathological sampling or draining thoraco-abdominal collections and abscesses. 

Needle biopsy is considered one of the most effective ways to collect samples of the cell or tissue from the body for laboratory testing. Usually, a common needle biopsy comes under two ways: 

• fine-needle aspiration 
• core needle biopsy 

Needle biopsy is conducted to extract tissue and fluid samples from different parts of the body, including the muscles and all other organs. This type of dialysis is done to treat diseases or disorders. Needle biopsy enables the chances of getting an accurate result. 

In case a sudden lump or mass is found on the body, and the doctor is unable to detect the source or reason for the lump, a needle biopsy is recommended. A needle biopsy may also be suggested by the doctor if an infection or inflammation of any kind is detected at a particular part of the body. 

Patients should consult the doctors in case there is any liquid oozing from the place biopsy is done. 

Other Techniques: 

There are several other techniques used in interventional radiology procedures, including clot retrieval or lysis, caval filters, aneurysm stents, and sclerotherapy. 

The lysis test is conducted to see how RBCs (or red blood cells) absorb complement components with the help of serum at a low ionic rate. Caval filter technique is another unusual interventional radiology procedure in which a filter is attached in a large vein at the abdomen that returns blood from the lower body to the heart. 

Most of the time, these blood clots can be noticed in the veins and pelvis, but they can reach the lungs, causing a blockage or pulmonary embolism. Caval filters are known to reduce the vulnerabilities of pulmonary embolism. This traps the clots and prevents them from entering the heart or lungs. These are some of the practical techniques that form a part of interventional radiology procedures. 

Advantages 

• Day case or short admission procedures 
• Less / no pain 
• More cosmetic - pinhole/spot dressing surgery 
• Less morbidity/complications 
• More rapid return to work 
• Does not close the door to conventional surgeries 
• Can be combined with other treatments like chemotherapy 

Conditions that can be treated include 

• Most uterine fibroids 
• Rest pain and claudication 
• Ischaemic diabetic foot 
• Varicose veins 
• Male varicocele and pelvic congestion syndrome 
• Benign prostatic hyperplasia 
• Recurrent haemoptysis, GI bleeds 
• Back pain 
• Curative treatment for small kidney, lung or liver tumours 
• Local control for larger tumours 
• Venous access and ports 
• Renal dialysis access 
• Bile duct and ureteric blocks 
• Complications of portal hypertension 

The Centre for Interventional Therapies at RTIICS, Kolkata and the Department of Interventional Radiology at MSMC, Bangalore, offer the latest technologies for minimally invasive treatments. They are staffed by experts trained in Interventional Radiology from across the world. 

Key facilities include: 

• Eastern India’s first DYNA CT 3D lab for superior guidance (RTIICS) 
• Dedicated Ultrasound for access, guidance, ablation, biopsies and injections 
• Dedicated CT for guided minimally invasive procedures 
• State-of-the-art theatre for guided combined procedures 

Interventional Therapy Clinics 

• Fibroid Clinic - Control fibroids without surgery 
• Vascular & Vein Clinic - Arterial and venous disease 
• Interventional Oncology - Minimally invasive cancer treatments 
• Biopsy Clinic - Any lesion anywhere 

Narayana Health is a centre of excellence in medical technological advancements that improve patient outcomes in a wide variety of conditions. 

For more details, call now to - 08062154546