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Departments » 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.

 

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

 

Removing of blocks in blood vessels: Blocks can occur in blood vessels anywhere in the body

 

  in the neck - leading to a stroke

Patient with acute stroke-vessel occlusion
recanalised with thrombolysis

 

  in the leg - leading to gangrene;

Blocked blood vessel to leg opened by stenting

 

  in the kidney - leading to renal failure and so on.

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.

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.

Aneurysm in brain treated by Coil Embolisation

 

AVM in brain treated by Embolisation

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.

Intracranial angioplasty / stenting

Carotid and vertebral angioplasty and stenting

Block in Carotid treated by Angioplasty & Stenting

Renal angioplasty and stenting

Peripheral angioplasty and stenting

Endovascular stent grafting

Aortic aneurysm are done in association with cardio thoracic surgeons

Hybrid procedure for aortic aneurysm

 

Advantages of Interventional Radiology

Only a short hospital stay is required for most procedures.

General anaesthesia is usually not required.

Risk, pain and recovery time are reduced compared to conventional surgery.

Relatively no scar as the surgery is performed through an incision of 1-4mm size.

 

Know your options

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”.

 

To know more about Pinhole Surgery, please visit www.pinholesurgery.in