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general perception is that radiologists only make diagnosis and are not
actually involved in treating disease. However, interventional radiology
provides treatment of certain diseases without the need for operation.
Interventional radiology plays a role in almost all disciplines of modern
medicine. Modifications of various techniques used in interventional
radiology have now extended to other areas of medicine (including surgery
and other surgical disciplines) and is called minimally invasive therapy.
Interventional radiology offers a more economical, faster and safer way of
treating disease without the need for major surgery. It is more economical
as it reduces the need for long hospital stay and may actually eliminate
it. Cost for the operation will be avoided. It is safer as the risks and
complications of a major surgery and general anaesthesia is avoided,
especially so in ill patients. Recovery period is shortened and
complications during recovery will also be reduced.
By
using the various types of imaging methods for guidance and special
needles, wires, tubes and catheters of various shapes and sizes,
radiologists are now able to treat disease in the body by going through
the body’s blood vessels or other routes. Therefore, these procedures are
done in the radiology department and not in the operating theatre. These
procedures can be divided into those that are done through blood vessels
and those done using routes other than blood vessels.
The
common procedures done through the blood vessels include:
1. Angioplasty
This procedure is performed to open up blocked or narrowed vessels to
increase blood flow. A special catheter called the balloon angioplasty
catheter is passed across the area of the blocked or narrowed artery. The
balloon is then inflated, resulting in reopening of the blockage or
narrowing. This method is now increasingly performed in treating narrowed
blood vessels in the heart and limbs. It is also possible to place fine
metal tubes called stents, in the vessels to keep them open.
2. Vascular embolisation
The
blood supply to tumours can be blocked off by using special material
either in the form of coils, foam or gel. This is used to control bleeding
before surgery. This method is also used to control bleeding following any
kind of accident and to occlude abnormal dilatations of blood vessels
(aneurysms).
3. Chemoembolisation
The
delivery of cancer medication as close to the cancer as possible using
fine tubes placed in the arteries is called chemoembolisation. This allows
higher doses of the drug closer to the cancer without some of the
complications that would be experienced in chemotherapy delivered through
your arm veins. Presently this is used often to treat cancers of the
liver.
4.
Thrombolysis
Dissolving blood clots by chemicals
as close to the clot as possible via catheters is called thrombolysis. The
alternative of which would be the need for surgery.
The
more common interventional procedures not done through blood vessels
include:
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Needle biopsies – Using very fine needles, radiologists are able to take
samples of tissue through the skin without the need for surgery. The
placement of the needles is guided using a variety of imaging techniques
from fluoroscopy, ultrasound, computed tomography and even magnetic
resonance imaging.
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Drainage procedures – This is done to relieve obstruction to the kidneys
and ducts in the liver as well as to drain pus or fluid collections in
most parts of the body.
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