Neurointerventional & Interventional Radiology

Common Conditions Treated by Neurointerventional Radiology

Neurointerventional radiology provides minimally invasive treatment options for several critical neurological and spinal conditions:

• Aneurysms: Brain aneurysms are managed with techniques like coiling, stent-assisted coiling, balloon-assisted coiling, or flow diverter stenting to prevent rupture.
• Arteriovenous Malformations (AVMs): AVMs, abnormal connections between arteries and veins, are treated with embolisation to reduce bleeding risks without surgery.
• Stroke: For ischemic strokes, neurointerventional radiologists perform mechanical thrombectomy to remove blood clots from blocked vessels, restoring blood flow to the brain.

• Carotid Artery Stenosis: Narrowing of the carotid arteries can be addressed with angioplasty and stenting, improving blood flow and reducing stroke risk.
• Spinal Vascular Malformations: Abnormal vascular formations in the spinal cord, such as spinal AVMs and dural arteriovenous fistulas, can be treated with targeted embolisation to prevent neurological damage and alleviate symptoms.
• Spinal Compression Fractures: Vertebroplasty or kyphoplasty are performed to stabilise fractures in the spine, alleviating pain and restoring spinal stability.

These targeted, image-guided treatments offer effective alternatives to traditional surgery with faster recovery times.

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Common Conditions Treated by Interventional Radiology:

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Vascular Interventions

• Peripheral Artery Disease (PAD): Managed with angioplasty and stenting to open narrowed or blocked arteries in the legs, improving circulation and reducing pain.
• Varicose Veins: Endovenous laser therapy (EVLT) or sclerotherapy is used to close varicose veins, alleviating symptoms and enhancing appearance.
• Peripheral and Central Venous Thrombosis Treatment:
  • Thrombectomy: Removal of blood clots from peripheral and central veins to restore blood flow and prevent complications.
  • Catheter-directed Thrombolysis: Direct delivery of thrombolytic agents to dissolve clots while minimizing systemic exposure.

‍Aortic Interventions:

• Endovascular Aneurysm Repair(EVAR): A minimally invasive procedure to treat abdominalaortic aneurysms by placing a stent-graft within the aorta to reinforce thevessel wall and prevent rupture.
• Thoracic Endovascular AneurysmRepair (TEVAR): Similar to EVAR, this technique is used forthoracic aortic aneurysms, providing a way to manage aneurysms without opensurgery.
• Aortic Dissection Repair: Endovascular techniques to treat aortic dissections, including thedeployment of stent-grafts to stabilize the aorta and restore blood flow.

• HemorrhoidEmbolization: Aminimally invasive procedure targeting blood vessels supplying hemorrhoids,reducing blood flow, and alleviating symptoms‍‍
  

Oncologic Interventions

Cancer Treatments and Interventions

• Tumor Ablation: Minimally invasive techniques destroy cancer cells within tumours by using extreme temperatures.
  • Radiofrequency Ablation (RFA): Uses high-frequency electrical currents to heat and kill cancer cells, commonly applied to liver, kidney, lung, and bone tumors.
  • Microwave Ablation (MWA): Uses microwave energy to treat larger tumors, effective in organs like the liver and kidneys.
  • Cryoablation: Freezes cancer cells to destroy them, suitable for kidney, liver, and some lung tumors.
• Chemoembolization: Delivers concentrated chemotherapy directly to the tumor by blocking (embolizing) its blood supply, especially effective for liver cancer. This method allows a high dose at the tumor site while sparing systemic exposure.
• Transarterial Radioembolization (TARE): Involves injecting radioactive beads into the arteries, supplying a tumor, targeting liver cancer with localised radiation, reducing damage to surrounding tissues.
• Biopsies: Image-guided biopsies are crucial for diagnosing and staging cancer.Interventional radiologists use imaging technologies like ultrasound, CT, or MRI to guide needle placement, obtaining tissue samples with high precision from difficult-to-access areas, minimising patient discomfort and risk. Biopsies are essential for confirming cancer type, determining prognosis, and personalised treatment plans.
• Biliary Interventions: Relieves bile duct obstructions caused by tumors by placing stents, which helps alleviate jaundice and other symptoms, improving liver function and quality of life.
• Port Catheter Placement: Implants a catheter port under the skin for easy access to chemotherapy and other medications, enhancing patient comfort and streamlining the treatment process.
• Palliative Care: Uses interventional techniques to manage symptoms such as pain, bleeding, and obstruction in advanced cancer cases, prioritizing patient comfort and quality of life.

Urologic Interventions

• Ureteral Stenting: Placement of stents in the ureters to relieve obstruction caused by kidney stones, tumors, or strictures, ensuring proper urine flow.
• Percutaneous Nephrostomy: Placement of a catheter through the skin into the kidney to drain urine when urinary flow is obstructed.
• Renal Biopsy: Image-guided renal biopsy for the safe collection of kidney tissue to assess conditions like cancer or inflammation.

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Gynecologic Interventions

• Uterine Fibroids: Uterine fibroid embolization (UFE) effectively reduces fibroid size, relieving symptoms like heavy bleeding and pelvic pain.
• Pelvic Congestion Syndrome (PCS): Treatment involves embolization of varicose veins in the pelvis to alleviate chronic pelvic pain and symptoms related to pelvic congestion.

Trauma Interventions

Trauma Interventions:

• Pelvic Fracture Management: Angiographic embolization of the internal iliac arteries to control pelvic hemorrhage and stabilize patients.
• Solid Organ Injury Management:
  • Splenic and Hepatic Embolization: Embolization techniques to control bleeding from splenic or liver injuries.Percutaneous Drainage:
  • Placement of catheters to drain fluid collections or hematomas resulting from trauma.
• Vascular Injury Repair: Endovascular stenting or bypass procedures for managing traumatic injuries to major vessels.

Other Interventions

• Dialysis Fistula Stenosis: Balloon angioplasty or stenting to restore and maintain proper blood flow in narrowed or blocked dialysis fistulas or grafts.
• Prostate Artery Embolization (PAE): A minimally invasive procedure to treat benign prostatic hyperplasia (BPH) by blocking blood flow to the prostate, reducing size and relieving urinary symptoms.
• Thyroid Nodule Ablation: Radiofrequency ablation (RFA) and microwave ablation (MWA) to treat benign thyroid nodules and hyperplastic tissue, reducing size and alleviating symptoms.
• Thyroid Gland Embolization: A procedure to selectively occlude the blood supply to the thyroid gland, which may be indicated in cases of hyperthyroidism or large goiters, reducing gland size and related symptoms.