Varicose veins :-
Pooling of blood in the veins from weak valves resulting in enlarged, swollen vessels causing pain and cosmetic complaints. Interventional endovenous laser treatment or sclerotherapy may be used to heat the vein from the inside, sealing it closed. Other healthy veins carry blood from the leg to reestablish normal flow.
Peripheral artery disease (PAD) :-
Most commonly a result of atherosclerosis, occlusion of normal blood flow in the upper and lower extremities may result in pain, skin ulcers, or gangrene. Stenting,angioplasty, and mechanical atherectomy are available interventional treatments.
Deep vein thrombosis (DVT) :-
The formation of a thrombus, or blood clot, in the deep leg veins which may lead to swelling, discoloration, and pain. DVTs can result post-thrombotic syndrome and pulmonary embolism. Post-thrombotic syndrome is irreversible damage from a long standing DVT in the affected leg veins and valves, leading to chronic pain, swelling, and severe skin ulcers. Pulmonary embolism is a life-threatening condition which occurs when a deep vein thrombus (DVT) breaks off and travels to the lungs, resulting in difficulty breathing. Catheter-directed thrombolysis, balloon angioplasty, or stenting may be performed in the affected vein to dissolve the clot and restore normal blood flow.
Pulmonary embolism :-
A potentially life-threatening occlusion of the arteries supplying the lungs with blood clots, manifesting in shortness of breath, fatigue, palpitations, and fainting. Catheter-directed thrombolysis may be performed for this condition, where a catheter is inserted into the leg, threaded up to the lung, and then used to infuse "clot-busting" drugs into the occlusion.
IVC filter placement :-
Patients who have a history of, or are at risk for, pulmonary embolism may receive temporary or permanent inferior vena cava (IVC) filters to prevent the migration of blood clots to the lungs, and consequently prevent recurrence of pulmonary embolism.
Abdominal aortic aneurysms (AAA) :-
A weakening and dilatation of the abdominal aorta wall that can result in abdominal or back pain, and potentially life-threatening bleeding if it ruptures. Interventional treatment of this condition via non-surgical means is endovascular aneurysm repair, using angiography and stenting to occlude the AAA and prevent its continued growth.
Thoracic aortic aneurysms (TAA) and Aortic dissection :-
Anuerysms, or dilatations, of the thoracic (chest cavity) aorta may be caused by atherosclerosis, syphilis, trauma, or multiple other conditions. Aortic dissections are tears in the thoracic aorta resulting from trauma or weakening of the aortic vessel walls from conditions such as hypertension, atherosclerosis, and congenital conditions such as Marfan syndrome. Interventional treatments for TAAs and aortic dissections utilize stent grafts, sometimes in combination with surgery, to prevent blood flow from enlarging the diseased area or rupturing the aorta.
Acute limb ischemia:-
The sudden disruption of blood flow to an arm or a leg due to arterial occlusion by a blood clot or other debris, potentially treated with catheter-directed thrombolysis or mechanical thrombectomy.
Acute mesenteric ischemia:-
A medical emergency resulting from interruption of the blood supply to the abdominal organs due to blockage of the mesenteric arteries or veins by thrombus, embolus, or aortic dissection. Treatment varies by etiology of the ischemia, but may include thrombolysis, stenting, or angioplasty.
Various interventional therapies exist to treat cancers. Tumor type, size, extent of disease, operator experience, and involvement of anatomical structures all factor into deciding which therapy is most appropriate. Some therapies, such as transarterial chemoembolization, block the blood supply to tumors. Other techniques--radiofrequency ablation (RFA),microwave (Thermo) ablation, cryoablation, irreversible electroporation (IRE), and high-intensity focused ultrasound (HIFU)—directly damage the cancerous tissue. All of these treatments are delivered locally, minimizing damage to nearby tissue and avoiding the systemic side-effects of chemotherapy.
Liver cancer :-
For liver cancer, curative treatment is liver resection or liver transplant; however, cryoablation, radiofrequency ablation, percutaneous ethanol injection, chemoembolization, and radioembolization are options for patients that are poor candidates for resection or transplantation.
Lung cancer :-
Surgery (lobectomy) remains the reference for treating early stage lung cancer; however, most patients are not surgical candidates at the time of diagnosis. For these patients, minimally invasive treatment options, including high-dose radiation therapies and percutaneous thermal ablation therapies such as radiofrequency aablation, microwave ablation, and cryoablation have emerged as safe and effective treatment alternatives.
Breast Cancer :-
Surgery remains the best curative option for patients with breast cancer. However, for those patients who aren't surgical candidate, minimally invasive options such as those offered by interventional radiologists remain a viable option. In particular, thermal ablation, including radiofrequency ablation and cryoablation, and laser ablationtherapies have been used to provide targeted therapies for breast cancer.
Stroke :-
A neurological condition occurring when the brain is starved of oxygen and nutrients resulting from the blockage of blood vessels supplying it (ischemic stroke) or from bleeding (hemorrhagic stroke). Symptoms include language, motor, sensory, and vision deficits. Interventional neuroradiologists play a critical role in determining the type of stroke (ischemic or hemorrhagic) using non-contrast computed tomography (CT) imaging or magnetic resonance imaging (MRI), and then treating the stroke using minimally invasive treatment, if possible. Strokes caused by blood clots can be treated by intra-arterial thrombolysis or by mechanical thrombectomy. Strokes caused by bleeding resulting from ruptured aneurysms may be treated by embolization, most commonly using tiny metal coils.
Carotid artery stenosis :-
A narrowing of the carotid artery supplying the brain which can lead to stroke and disability. Carotid artery stenting (CAS) is an alternative to surgical carotid endarterectomy (CEA) which may be performed in patients who have symptomatic carotid atherosclerotic disease but who are poor candidates for open surgery.
Multiple Sclerosis :-
Angioplasty of the cervical veins has been suggested as an interventional treatment of chronic cerebrospinal venous insufficiency (CCSVI) that, hypothetically, contributes to the pathogenesis of multiple sclerosis.[8] This hypothesis is highly controversial [9] and treatment of CCSVI by methods of interventional radiology is encouraged only in context of research.
Spinal fractures :-
Spine Spinal fractures Vertebroplasty and kyphoplasty, the percutaneous injection of biocompatible cement into fractured vertebrae, are two available treatments for vertebral fractures.
Portal hypertension :-
A condition in which the normal flow of blood through the liver is slowed or blocked by scarring (cirrhosis) or other damage (e.g. hepatitis). Patients with the condition are at risk of internal bleeding or other life-threatening complications. Transjugular intrahepatic portosystemic shunt (TIPS) formation is a minimally invasive treatment to alleviate this impaired blood flow.
Bile Duct Obstruction :-
Patients with liver cancer, bile duct cancer, cholecystitis, cholangitis, or other hepatobiliary pathology may experience obstruction of bile ducts. Interventional radiologists commonly perform procedures such as percutaneous transhepatic cholangiography (PTHC or PTC) to image these obstructions, and may treat these conditions using percutaneous transhepatic biliary drainage (PTBD), wherein catheters or stents are placed through the skin and into the bile ducts to drain the bile for prolonged periods of time or until.
Bile Duct Obstruction :-
Patients with liver cancer, bile duct cancer, cholecystitis, cholangitis, or other hepatobiliary pathology may experience obstruction of bile ducts. Interventional radiologists commonly perform procedures such as percutaneous transhepatic cholangiography (PTHC or PTC) to image these obstructions, and may treat these conditions using percutaneous transhepatic biliary drainage (PTBD), wherein catheters or stents are placed through the skin and into the bile ducts to drain the bile for prolonged periods of time or until.
Uterine fibroids are non-cancerous growths of the muscular portion of the uterus which may cause pain and heavy bleeding. Interventional radiologists are able to perform non-surgical, minimally invasive treatments of uterine fibroids, called uterine fibroid embolization (UFE), or uterine artery embolization (UAE), using real-time imaging. In this procedure, the interventional radiologist accesses the uterine arteries via a catheter in the femoral or radial artery. The physician guides the catheter into the uterine arteries that supply blood to the fibroid and then releases tiny particles or coils through the catheter to occlude the blood supply of the tumor, causing it to shrink and die. Fibroid embolization may require a hospital stay of one night, but is often done safely as an outpatient procedure.[12] A procedure without complications can take as little as 30 minutes and the patient can stand up and walk out of the OR unaided. On average, 85-90 percent of women who have had the procedure experience significant or total relief of heavy bleeding, pain and/or bulk-related symptoms. Recurrence of fibroids treated by UFE is very rare.
Uterine fibroids are non-cancerous growths of the muscular portion of the uterus which may cause pain and heavy bleeding. Interventional radiologists are able to perform non-surgical, minimally invasive treatments of uterine fibroids, called uterine fibroid embolization (UFE), or uterine artery embolization (UAE), using real-time imaging. In this procedure, the interventional radiologist accesses the uterine arteries via a catheter in the femoral or radial artery. The physician guides the catheter into the uterine arteries that supply blood to the fibroid and then releases tiny particles or coils through the catheter to occlude the blood supply of the tumor, causing it to shrink and die. Fibroid embolization may require a hospital stay of one night, but is often done safely as an outpatient procedure.[12] A procedure without complications can take as little as 30 minutes and the patient can stand up and walk out of the OR unaided. On average, 85-90 percent of women who have had the procedure experience significant or total relief of heavy bleeding, pain and/or bulk-related symptoms. Recurrence of fibroids treated by UFE is very rare.
Pelvic congestion syndrome :-
A condition caused by pooling of blood in the pelvic veins, possibly resulting in pelvic pain and lower extremity varicose veins. Interventional vein embolization is possible in some cases, eliminating the need for surgical removal of the ovaries and/or uterus.
Infertility :-
One cause of female infertility is the blockage or narrowing of the fallopian tubes through which eggs pass from the ovary to the uterus. This cause of infertility may be diagnosed using selective salpingography and treated by opening the narrowing using a minimally invasive device such as a balloon.
Renal artery stenosis :-
A narrowing of the arterial supply of the kidneys which may result in high blood pressure (hypertension) or renal insufficiency. Diagnosis of these conditions is made by measuring the diameter of stenosis, the blood pressure across the area of stenosis, renal vein renin sampling, and captopril challenge testing. Stenosis may be treated byballoon angioplasty or stenting.
Renal failure/Dialysis catheter placement :-
Patients in renal failure may require the placement of a hemodialysis catheter prior to initiating hemodialysis for renal failure.
Dialysis fistula/Arterio-venous graft clot :-
Dialysis fistulae and grafts may become occluded by blood clots, requiring an interventional "declot" procedure in which mechanical or chemical thrombolysis is performed to eliminate the clot.
Dialysis fistula/Arterio-venous graft failure :-
Dialysis fistulae and grafts may fail to "mature", resulting in the need to image the fistula and potentially relieve any blockages using angioplasty.
Nephrostomy tube placement :-
In conditions where a blockage exists between the kidney and the urethra, such as with kidney stones, a tube may be placed into the kidney under imaging guidance to allow the drainage of urine and to prevent kidney damage.
Renal Sympathetic Denervation :-
An ablation catheter can be used to denervate the renal arteries in resistant hypertension, often reducing the blood pressure.
Gastric varices:-
A condition in which blood flow through the vessels around the stomach is slowed or stopped, potentially resulting in bleeding. Interventional treatments include embolzation and balloon-retrograde transverse obliteration (BRTO).
Varicoceles and male infertility:-
A dilatation in the veins of the scrotum which can result in pain, swelling, and infertility. It is potentially treated interventionally using embolization and sclerotherapy.
Central venous access:-
Vascular access and management of specialized kinds of vascular access devices (VADs). Vascular access devices include nontunneled catheters such as PICC lines, tunneled catheters such as Hickman lines, and fully implanted devices or subcutaneous ports. Access sites include arm/leg veins PICC lines as well as jugular, subclavian and femoral veins and in some cases the inferior vena cava is directly accessed by translumbar and transhepatic routes.
Percutaneous drains:-
Drainage of fluid from various body compartments using catheters and drains placed through the skin (e.g., abscess drains to remove pus, pleural drains).
Gastrostomy tube placement:-
In instances where patients are unable to take food by mouth, a feeding tube may be placed through the skin and into the stomach using imaging guidance.
Biopsies:-
Samples of tissue may be required to identify the cause of certain diseases. Using imaging guidance, interventional radiologists may minimally invasively reach underlying tissue using a small needle to pierce the skin and retrieve tissue samples from the target organ.
Pediatric interventions
Minimally invasive procedures commonly performed in children include obtaining central venous access, gastrostomy tube placement, diagnostic angiography, biopsies, and percutaneous drainage
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