Interventional radiology is rapidly developing and one of the most technically advanced fields in modern medical practice. Patients are treated with minimally invasive techniques using image guidance. Today, many conditions that once required surgery can be treated by interventional procedures with equal or better outcomes and in some situations it is the only available treatment to prevent mortality or significant morbidity.
Hence it can be identified as the surgical wing of radiology.
These minimally invasive interventions can reduce infection rates and recovery time, as well as shorten hospital stay.
Many of the procedures are currently practiced successfully in Sri Lanka with results comparable to the rest of the world.
Neuro-interventional procedures including endovascular embolization of cerebral aneurysms and cerebral AVMs are replacing major neurosurgery and performed with minimal physical and psychological trauma. This has changed the horizon for patients who suffer from these acute conditions, while clot retrieval in cases of acute stroke is becoming an essential component of an advanced medical practice.
The availability of an advanced procedure such as mechanical clot retrieval in patients with acute stroke has revolutionized the potential outcomes for these patients, offering them a chance of a fully functional life vs. death or permanent disability.
Disease/ Condition |
Minimally Invasive Endovascular Management |
| 1. Peripheral Interventions | |
|
* Arterial occlusive disease |
- Angioplasty / stenting |
|
* Peripheral vascular/ aortic Aneurysms/ pseudoaneurysms |
- Endovascular stenting / stent graft |
| * Deep vein thrombosis+/- pulmonary embolism | - Placement of IVC filter |
|
* Varicose veins |
- Microwave/ RFA ablation |
|
* Peripheral arterio venous malformations |
- Endovascular embolization |
|
* Peripheral vascular tumours |
- Preoperative embolization to reduce blood loss |
| 2. Genitourinary Interventions | |
|
* Hydronephrosis due to ureteric Obstruction |
- Percutaneous nephrostomy + stenting |
|
* Varicocele |
- Testicular vein embolization |
|
* Uterine fibroids |
- Embolization of uterine artery |
|
* Renal artery stenosis |
- Renal artery angioplasty +/- stenting |
|
* Post-partum haemorrhage |
- Endovascular embolization |
|
* AV fistula or acute renal bleeding following trauma |
- Embolization of segmental intra renal arteries |
| 3. Gastrointestinal Interventions | |
|
* GI pseudoaneurysms, angiodysplasia /ulcers |
- Endovascular embolization |
|
* Hypersplenism due to splenomegaly |
- Embolization of splenic artery |
| 4. Pulmonary Interventions | |
|
* Pulmonary AVM/ Aneurysms |
- Endovascular embolization |
|
* Bronchiectasis/ Mycetoma following Past TB |
- Endovascular embolization |
| 5. Hepato - biliary Interventions | |
|
* Biliary obstruction |
- Percutaneous biliary drainage/ stenting |
|
* Hepatoma/ Vascular liver secondaries |
- Trans Arterial Chemo Embolization (TACE) |
|
* Liver tumours awaiting lobectomy |
- Percutaneous portal vein embolization |
|
* Liver/ lung/ renal tumours |
- Guided radio frequency ablation |
|
* Portal hypertension |
- Trans Jugular Intra Hepatic Porto-systemic shunt (TIPS) |
|
* Budd chiari syndrome |
- Percutaneous hepatic venoplasty |
|
* Liver parenchymal disease |
- Trans-jugular liver biopsy |
| 6. Head, neck and spinal interventions | |
|
* Cerebral aneurysms |
- Coil embolization/ placement of flow diverter stent |
|
* Carotico cavernous fistula |
- Endovascular embolization |
|
* Dural arterio venous fistula of brain or spine |
- Endovascular embolization |
|
* Cerebral or spinal arterio venous malformation |
- Endovascular embolization |
|
* Vein Galen malformation |
- Endovascular embolization |
|
* Vascular tumours of brain and spine Eg: Meningioma/ paragangliomas |
- Preoperative embolization to reduce blood loss |
|
* Scalp arterio venous malformations |
- Percutaneous embolization |
|
* Pituitary microadenoma |
- Petrosal sinus venous sampling |
|
* Carotid artery stenosis |
- Carotid artery angioplasty and stenting |
|
* Acute stroke |
- Endovascular clot retrieval |
|
* Vascular malformation/ post traumatic epistaxis |
- Endovascular embolization |
|
* Vertebral collapse |
- Vertebroplasty |
|
* Disc prolapse |
- Ozone therapy |
