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INTERVENTIONAL RADIOLOGY AS MINIMALLY INVASIVE PROCEDURES

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INTERVENTIONAL RADIOLOGY AS MINIMALLY INVASIVE PROCEDURES Radka Slipac Department of Radiology Brno, Czech Republic What is Interventional Radiology? – PowerPoint PPT presentation

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Title: INTERVENTIONAL RADIOLOGY AS MINIMALLY INVASIVE PROCEDURES


1
  • INTERVENTIONAL RADIOLOGY AS MINIMALLY INVASIVE
    PROCEDURES
  • Radka Slipac
  • Department of Radiology Brno, Czech Republic

2
What is Interventional Radiology?
  • Interventional radiology procedures are minimally
    invasive, targeted treatments.
  • Interventional radiologists use imaging
    equipments such as X-rays, ultrasound, CT and MRI
    to guide small instruments such as catheters or
    wires through the blood vessels or other pathways
    to treat as well as diagnose diseases
    percutaneously.

3
What are the Advantages of Interventional
Radiology?
  • Interventional radiology procedures are generally
    easier for the patient because
  • no general anesthesia
  • no large incisions
  • outpatient basis
  • less risk
  • less pain
  • less blood loss
  • less recovery times
  • less expensive

4
What Procedures do Interventional Radiologist
Perform?
  • Balloon angioplasty
  • Biliary drainage and stenting
  • Chemoembolization
  • Embolization
  • Radiofrequency ablation (RFA)
  • Stenting
  • Stent-graft
  • Thrombolysis
  • TIPS (transjugular intrahepatic
    portosystemic shunt)
  • Cryotherapy
  • Blood clot filters

5
CHEMOEMBOLIZATION
  • Used mostly to treat primary liver cancers and
    metastases of the liver. In about two-third of
    cases the tumors are stopped or shrunk.
  • Using this unique principle
  • The liver receives about 85 of its blood supply
    through the portal vein and only 15 through the
    hepatic artery.
  • But the tumor receives almost all of its supply
    from the hepatic artery.

6
How Does Chemoembolization Work?
  • Attacks the cancer in two ways
  • very high concentration of chemotherapy in the
    tumor is achieved by direct delivery through the
    hepatic artery, sparing most of the healthy liver
    tissue
  • ischaemia of the tumor is caused by embolization
    of nourishing artery with embolic particles
  • This treatment preserves liver function and
    relatively normal quality of life.

7
Superselective Chemoembolization of a Sole Liver
Metastasis
8
Chemoembolization of LiverMetastases of Gastric
Cancer
1. before TCE 2. regression
after 6 months 3. stabilized after 9 months
9
EMBOLIZATION
  • Highly effective way of controlling bleeding from
    injury, esp. in abdomen or pelvis, or stomach
    ulcer, in an emergency situation.
  • Worldwide succesful treatment of uterine fibroids
    with reduced menstrual bleeding, pelvic pain and
    other complaints as an alternative to the
    surgical removal of the uterus.
  • Effective treatment of tumors that either cannot
    be removed surgically or would involve great risk
    of surgery.

10
How Does Embolization Work?
  • Delivery of clotting agents directly to a
    bleeding or problematic area.
  • Temporary embolic agents such as Gelfoam (a
    gelatin sponge material) block vessels for enough
    time (days to weeks) for the body to heal the
    problem causing the bleeding, f.e. injury or
    gastric ulcer.
  • Permanent embolic agents such as Polyvinyl
    alcohol (PVA) occlude vessels parmanently, f.e.
    are used to embolize uterine fibroid tumors.

11
Bleeding from a Stomach Ulcer
Selective
arteriography Stopped after
of left gastric artery
Gelfoam embolization
12
Bleeding from Jejunum
Arteriography of superior Stopped after
superselective mesenteric artery
metal coils embolization
13
Uterine Fibroid Embolization
Angiography of right uterine artery and
embolization
MRI of uterine fibroid visible before and
invisible 6 months after embolization
14
AORTIC STENTGRAFTS
  • Endovascular repair of abdominal aorta aneurysm
    (AAA) with a fabric-wrapped flexible mesh tube.
  • Prevention of enlargement or life-threatening
    rupture of AAA.
  • Less invasive, less blood loss, effective and
    safe alternative especially for patients with
    great risk of surgery.

15
How Does Aortic Stentgrafts Work?
  • An appropriate type of self-expanding stentgraft
    is inserted through the femoral artery and placed
    at the site of the aneurysm of abdominal aorta.
  • Stentgraft bridges the aneurysm inside and
    eliminates the blood flow in aneurysmal sac.
  • Reduction of the aneurysmal sac and decrease of
    the pressure on the aortic wall as an effective
    prevention of rupture.

16
Various Aortic Stentgrafts
17
Aortic Stentgrafts
18
Subrenal Abdominal Aortic Aneurysm
Angiography before and after implantation of
stentgraft
19
Implantation of Bifurcated Aortic Stentgraft
Aortography before CT after 6 months
CT after one year
20
CONCLUSIONS
  • Interventional radiology procedures are an
    advance in medicine that often replace open
    surgical procedures.
  • These minimally invasive procedures involve less
    blood loss and thus play an important role in
    bloodless medicine.
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