Interventional RadiologyInterventional Radiology

Radiology has provoked from Radiology has provoked from providing purely diagnostic providing purely diagnostic information to information to therapytherapy, offering , offering effective effective alternativesalternatives in the Rx . in the Rx .

Percutaneous BiopsyPercutaneous Biopsy

Fuoroscopy.Fuoroscopy.

US guided biopsyUS guided biopsy

CT guidance CT guidance

Drainage of abscesses and Fluid Drainage of abscesses and Fluid collectionscollections

Almost any fluid collection in the Almost any fluid collection in the chest, abdomen or pelvis may be chest, abdomen or pelvis may be considered for percutanous catheter considered for percutanous catheter drainage, which has largely replaced drainage, which has largely replaced surgery as the initial treatment of surgery as the initial treatment of choice. choice.

Percut. Biliary drainagPercut. Biliary drainag

Through PTC…….optionsThrough PTC…….options- Balloon dilatation.Balloon dilatation.- Simple external drainage.Simple external drainage.- Internal/external drainage.Internal/external drainage.- Stent insertion (plastic or expanding Stent insertion (plastic or expanding

metal)metal)

Transjugular intra-hepatic Transjugular intra-hepatic portosystemic shunt (TIPSS)portosystemic shunt (TIPSS)

Percut. creation of a communication Percut. creation of a communication bet. the portal & hepatic venous bet. the portal & hepatic venous systems for the relief of portal systems for the relief of portal hypertension. It is an alternative to hypertension. It is an alternative to surgery in patients with recurrent surgery in patients with recurrent variceal bleeding who are resistant variceal bleeding who are resistant to sclerotherapy or endoscopic to sclerotherapy or endoscopic banding. banding.

PERCUT. RENAL PERCUT. RENAL INTERVENTIONINTERVENTION

Percut. nephrostomy:Percut. nephrostomy:

The most common indication is relief The most common indication is relief of urinary obst. to preseve renal of urinary obst. to preseve renal function or to allow successful function or to allow successful treatment of infection.treatment of infection.

The procedure is usually best The procedure is usually best performed under combined US & performed under combined US & fluoroscopic control.fluoroscopic control.

PERCUT. RENAL INTERVENTIONPERCUT. RENAL INTERVENTIONAntegrade ureteric stent Antegrade ureteric stent

insertioninsertion

INTERVENTIONAL VASCULAR INTERVENTIONAL VASCULAR TECHNIQUESTECHNIQUES

A wide range of interv,. vascular A wide range of interv,. vascular techniquestechniques

has developed from basic angiographichas developed from basic angiographic

principles and has a profound impact principles and has a profound impact on on

many aspects of medicine & surgery.many aspects of medicine & surgery.

Interv. Vascul. techniquesInterv. Vascul. techniques

Percut. transluminal angioplasty:Percut. transluminal angioplasty:A deflated balloon is inserted through A deflated balloon is inserted through

a guidewire into a stenosis or a guidewire into a stenosis or occlusion & then inflated.occlusion & then inflated.

Vascular stenting: Vascular stenting:

For osteal renal artery stenosis For osteal renal artery stenosis stents have been shown to be stents have been shown to be superior to balloon angioplasty alone.superior to balloon angioplasty alone.

Intervent. Vascular Intervent. Vascular Techniques..cont.Techniques..cont.

Intravascular thrombolysis:Intravascular thrombolysis: Thrombolytic agents can be used to treat Thrombolytic agents can be used to treat

thrombo-embolic dis.thrombo-embolic dis. IVC filters:IVC filters: In pat. with contraindication to, or recurent In pat. with contraindication to, or recurent

emboli despite anticoagulation.emboli despite anticoagulation. Therapeutic embolisation:Therapeutic embolisation: Vacular tumors.Vacular tumors. AVMAVM