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Departments
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Interventional Radiology
Interventional Radiology is a new specialty, which
treats patients using Minimally Invasive Techniques,
usually as an alternative to traditional open surgery.
This
important subspecialty of Radiology, contributed to some
of the most significant medical developments. Most
patients will have heard of "keyhole surgery" but
interventional radiologists go one step further and
perform "pinhole surgery".
Interventional Radiologist
Interventional radiologists are doctors trained in
radiology and experts in reading X-rays, Ultrasounds,
CAT scans and other medical images.
This
expertise with imaging techniques enables them to guide
small catheters (Catheter is a small tube that can be
inserted into a body cavity, duct or vessel, measuring
just 1-4 mm) and guide-wires through blood vessels to
treat many diseases.
In fact,
interventional radiology is termed “pinhole surgery”
because of the small holes that are made in the skin to
perform these procedures.
Expertise in
Radiology allows the Interventional Radiologist to
locate and navigate to the exact location in the human
body which requires medical attention. Flat panel cath
lab with 3D rotational angiography is available for
performing advanced interventions in the whole body.
Problems related to blood vessels in the entire body are
treated in the cath lab today with minimally invasive
techniques – known as the pinhole surgeries. The
Department of Interventional Radiology specializes in
the following procedures
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Removing of
blocks in blood vessels: Blocks can occur in blood
vessels anywhere in the body |
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in the neck -
leading to a stroke
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Patient with acute stroke-vessel
occlusion
recanalised with
thrombolysis |
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in the leg -
leading to gangrene;
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Blocked blood vessel to leg opened
by stenting |
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in the kidney
- leading to renal failure and so on.
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Opening of blocked Kidney Vessel |
Previously, re-establishing blood flow in
these cases involved surgery. But by pinhole
surgery they can be carried out with local
anesthesia. A catheter is inserted through
the groin vessel (chosen because it’s the
widest vessel) and using imaging guidance
navigate beyond the obstruction and insert a
stent to restore the blood flow. |
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Embolisation:
Pinhole surgery is also used to control abnormal bleeding
anywhere in the body. This is called embolisation -
performed for acute life threatening diseases like coughing
up blood, uncontrolled bleeding in the intestines, during
childbirth etc. The conventional treatment for these was
blood transfusions. Now, with pinhole surgery,
Interventional Radiologist identifies the site of the blood
loss and use the catheter to access the blood vessel and
block it with chemical agents.
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Aneurysm in brain treated by Coil
Embolisation |
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AVM in brain treated by Embolisation |
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Tumor
treatment: Using the same technique we can block the
blood supply to tumours thereby ‘starving’ them. Similarly,
liver tumours can be “cooked” using radio frequency waves or
chemo - therapy can be administered directly (direct
chemotherapy to inoperable tumours bringing new hope to
cancer patients) to them. |
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Intracranial angioplasty / stenting |
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Carotid and vertebral angioplasty and stenting
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Block in Carotid treated by
Angioplasty & Stenting |
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Renal
angioplasty and stenting |
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Peripheral angioplasty and stenting |
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Endovascular stent grafting |
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Aortic aneurysm are done in association with cardio thoracic
surgeons
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Hybrid procedure for aortic aneurysm |
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Advantages of Interventional Radiology
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Only a short
hospital stay is required for most procedures. |
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General
anaesthesia is usually not required. |
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Risk, pain and
recovery time are reduced compared to conventional surgery. |
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Relatively no
scar as the surgery is performed through an incision of
1-4mm size. |
Pinhole surgery is available for many
diseases (diseases in heart, brain, kidney, etc…),
but few patients know to ask about them, or to seek
a second opinion from an Interventional Radiologist.
Usually patients do not have direct contact
with interventional radiologists. General
practitioners still refer their patients to surgeons
and rely on the surgeon to provide advice on
available treatment options.
Surgeons may or may not know the minimally
invasive treatments that another specialty offers.
Eventually this situation will change and patients
will be sent to the least invasive practitioner for
consult first, but in the meantime, it is important
for you to know that you may have a “pinhole
option”.
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