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Interventional radiology in India

What Interventional radiology

Interventional radiology (IR), sometimes known as vascular and interventional radiology (VIR), is a medical sub-specialty which provides minimally invasive image-guided diagnosis and treatment of disease. Although the range of procedures performed by interventional radiologists is broad, the unifying concept behind these procedures is the application of image guidance and minimally invasive techniques in order to minimize risk to the patient.

Historically, radiology doctors who regularly used x-ray imaging for the purpose of diagnostic testing were some of the first physicians to use imaging to direct medical procedures. Radiologists pioneered the use of catheter-based techniques such as angioplasty and catheter-delivered stent placement, which are now commonly used by other interventional medical specialties such as interventional cardiology.

Presently, IR physicians use x-ray, ultrasound, CT, and MRI imaging to perform a variety of procedures using needles and small catheters instead of surgical incisions. Thus, some conditions which previously required open surgery can now be treated non-surgically by an interventional radiologist.

Blood vessel disease

Narrowing of arteries leading to restricted blood flow (peripheral vascular disease): Interventional radiologists treat this by using balloons to stretch the vessel (balloon angioplasty, PTA) and sometimes metal springs called stents to hold them open. Sometimes arteries or bypass grafts block suddenly with a rapid loss of blood supply to the limb. Unless the blood supply is restored this can lead to amputation. Interventional radiologists can help by infusion of clot busting drugs directly into the artery via small catheters thus saving many limbs.

Expanded arteries (aneurysms) at risk of rupture and bleeding: IRs treat these by relining the vessel with a tube called a stent graft

Bleeding (haemorrhage). This is the most common vascular emergency treated by IR. Haemorrhage can come from almost anywhere e.g. from the gut, secondary to major injury or following birth. Bleeding can often permanently be stopped by blocking the vessel (embolization), relining the vessel with a stent graft or by blowing up a balloon in the vessel to stop the bleeding until emergency surgery can be performed. Interventional radiology is also used to prevent bleeding during some sorts of surgery e.g. during caesarean section in patients with a high risk of bleeding from an abnormal placenta (post partum haemorrhage).

Interventional Radiology

Tumour therapies: these treatments are intended to shrink or destroy tumours at their primary site or which have spread to other areas (metastases). This is an area of increasing interest and leading to improved survival with reduced morbidity.

Liver, kidney and other tumours (e.g. bone, lung):these can be treated by destructive therapies (ablation) usually involving heat (radiofrequency, laser, microwave, ultrasound) or cold damage (cryotherapy). The treatment is performed and monitored using imaging (ultrasound, computed tomography or magnetic resonance imaging).

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