Interventional radiology (abbreviated IR) is a medical sub-specialty of radiology that utilizes minimally invasive image-guided procedures to diagnose and treat diseases in nearly every organ system. Digital Subtraction Angiography (DSA) lab is where all the interventional procedures take place. DSA is essentially a type of fluoroscopic technique that digitally subtracts ‘pre-contrast image’ from ‘contrast image’ to clearly visualize the area of interest in a bony or dense soft tissue environment. At Jaslok, we have ‘Siemens Axiom Artis FA’ DSA imager with 3D rendering, large 40cm image intensifier and bolus change peripheral angiography.
Advantages of interventional radiological procedures compared to open surgeries:
Early recovery, shorter hospital stay A few examples of procedures done in the interventional radiology department are cited below:
- Minimally invasive.
- Therapy is delivered via catheters and wires through a needle puncture, whether vascular or non- vascular.
- Usually requires only local anaesthesia and sedation. Only some of the major therapeutic procedures like coiling of intracranial aneurysm require general anaesthesia.
- Patients with high risk and inoperable conditions can also be treated.
- Significantly lower complication rate
a. Stroke, - When diagnosed within the golden window of 6 hours, restoration of blood supply to the affected part of the brain can potentially reverse or minimize the extent of damage. The interventional radiologist plays a key role by dissolving the blood clot in affected artery before the brain damage becomes irreversible.
b. Bleed within the brain (subarachnoid / intraparenchymal / intraventricularhaemorrhage) can have catastrophic presentations and outcome. Some of the treatable causes for this condition include intracranial aneurysm and AV Malformation. Both these entities can be tackled by minimally invasive techniques and have excellent results.
c. Angioplasty and Stenting: for narrowed and diseased blood vessels thereby improving blood supply to the affected organs
d. Hepato-biliary interventions: Transarterialembolisation (blocking blood supply) of inoperable primary liver cancer and some metastatic lesions. Budd Chiari and veno-occlusive disorders affecting liver can be treated with interventional radiology procedures such as venoplasty, stenting and TIPSS. Both benign and malignant causes of biliary obstruction can be treated by enhancing internal drainage with the help of a stent or creating an external drainage.
h. Sudden torrential Gastro-intestinal or bronchial bleeding is potentially life threatening and requires urgent attention. The bleeder can be accurately diagnosed and blocked using interventional techniques.
i. Renal procedures: Drainage of obstructed urinary system can be done in native as well as transplanted kidney. It not only relieves acute symptoms but also avoids impending failure.