Interventional Radiology (IR)

Introduction to Interventional Radiology

Lesson Objectives

• (Need to be provided - not on master list)

What is Interventional Radiology?

Minimally invasive non-surgical image-guided procedures

Image Guidance

• Fluoroscopy
• Ultrasound
• CT
• MR
• Or combination of these!

Vascular access

• Port placement
• Tunneled catheter placement
• PICC placement
• Uses combination of ultrasound and fluoroscopy

Emergency Interventions

• Embolization of traumatic bleeding vessel/organ
• GI bleed
• Thrombolysis of blood clots
• Abscess drainage

Neurointerventional Radiology

• Stroke thrombectomy
• Cerebral aneurysm coiling
• Vertebral compression fractures – bone cement injected into fractured vertebra to stabilize and relieve pain
• Kyphoplasty
• Vertebroplasty

Vascular Interventions

• Venous malformations
• Arteriovenous malformations
• Lymphatic malformations
• Varicose veins

Interventional Oncology

(images should be replaced with UVM Health images

Image-guided biopsy

• Ultrasound
• CT
• MR – used less commonly

Thermal ablation of tumors – CT guided

• Cryoablation
• Radiofrequency
• Microwave•

Can be palliative option in patients who aren't surgical candidates

In appropriately selected patients, can be as effective as surgical resection

Endovascular embolization of liver tumors

• Chemotherapy beads
• Radiation beads (90Yttrium)

Hepatobiliary Interventions

Paracentesis

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

• •Used to shunt blood from portal vein to hepatic vein to decrease portal hypertension
• •Refractory ascites
• •Refractory variceal bleeding

Percutaneous cholecystostomy

• Used for patients with cholecystitis unable to undergo immediate cholecystectomy

Biliary stent placement

Renal Interventions

Obstruction – due to stones, tumor, or ureteral stricture

• Nephrostomy tube
• Ureteral stent
• Stone retrieval

Renal artery stenosis – leads to hypertension

• Renal artery angioplasty and/or stenting

Quiz

Summary

• Interventional radiologists perform procedures involving nearly every body system
• Non-surgical, minimally invasive
• Avoid morbidity of surgery
• Non-surgical candidates

Image guided

• Fluoroscopy (x-ray)
• Ultrasound
• CT
• MR