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Radiology

Radiology


Interventional Radiology is not a surgical treatment method.

In interventional radiology, vascular occlusions and diseases caused by hardening of the vessels are treated. In addition, the interventional radiology is used in the treatment of oncological diseases, especially in liver, kidneys, pancreatic and lung cancer. It is effectively used in the treatment of leg varices and in the aortic aneurysm.

Medicine is moving towards new technological treatments. Treatment methods, which are carrying out with advanced technology in a way to treat the patient with the least pain and discomfort is applied.
At the Interventional Radiology a high advanced technology, which alows to performe the procedures without surgical intervention with the use of special devices such as Computerized Tomogrophy, Magnetic Resonance, Ultrasonography and Angiography is applied. In addition, it covers the treatment methods applied with very specially manufactured medical materials and the by-products coming after them.

Duration of procedures in interventional radiology is shorter than the duration of a surgical procedure. This leads to fewer complications and subsequent disadvantages. General anesthesia is usually not required. The longest process does not exceed two hours. No serious preparation is required before moving on to interventional radiology. When the patient decides to undergo an interventional radiology course, it is enough for him not to eat after 12.00 a.m at night. It is enough for them to come in the morning on an empty stomach and bring their medicines, if they use them.

Who Performs Interventional Radiology Procedures?

Interventional Radiology practices are performed by radiologists and interventional radiologists with special training in radiology. They have to know both the surgical branches, the internal branches and the anatomy very well. They should be able for timely and completely following new technologies and new information.

Interventional Radiological Treatments and Diseases

  • Interventional radiological procedures for cerebral vascular diseases. Usually done to prevent brain bleeding and paralysis.
  • Treatment of bubbles (aneurysm) formed in the vessels of the brain through the vein
  • Treatment of brain AVM (arteriovenous malformations)
  • In case of a newly emerged stroke-paralysis, intervention is made within hours to open the occluded brain vein.
  • Stenosis or blockage of the carotid artery, which interferes with the nutrition of the brain and creates a risk of stroke, is prevented by installing a balloon or stent with a special filter in the lumen of the cerebellum vein.
  • Intravenous therapy of diabetes and related problems of lack of nutrition of the legs (skin changes, bruises, wounds, ulcers)

Interventional Radiological Procedures for Vascular Diseases:

  • Uterine artery embolization (EMA) is a modern method of treating uterine fibroids without surgery. The effect is achieved by blocking the blood flow in the nodes of the fibroids using a special drug that is injected into the uterine arteries through a thin tube (catheter) through the thigh.
  • Stenosis and blockages, especially in patients with difficulty in walking or with foot wounds due to leg vessels, clogged vessels, opened with balloons and stents.
  • Recanalization of renal vessels in patients with renal vascular stenosis and associated high blood pressure using interventional radiological methods.
  • Renal vessels recanalization in patients with renal vascular stenosis and associated high blood pressure using interventional radiological methods.
  • Repair of the aortic balloon vessel (aortic aneurysm) of the main artery of the body, with a specially sheathed stent.
  • Opening of stenosis and obstruction in vascular fistulas opened for dialysis in hemodialysis patients.
  • Insertion of filters into the vein (Vena Cava), that prevent blood clots from entering the lungs in patients at risk for pulmonary embolism.
  • Treatment with laser and interventional applications performed intravenously with imaging in cases of varicose and venous insufficiency.
  • Other embolization procedures are used in bleeding or treatment of abnormal tissue by blocking the sick tissue or the nutrient vessels of the mass in the organ individually, excluding them from the bloodstream.
  • With gastric, intestinal and internal bleeding, lung bleeding and organ damage, penetrating a vein using angiography, you can block a vein and stop the bleeding.
  • Angiography and interventional procedures apply to all vessels of the body except coronary vessels.

Interventional Radiological Procedures for Tumor Therapy in Cancer Patients:

  • In case of liver tumors and cancerous tumors spreading to the liver, penetrating from the vein into the tumor, special drugs are given to the cancerous tissues of the tumor, which also cure vascular occlusion (chemoembolization).
  • Using similar methods, in radioembolization procedures, point shots with the radioactive material, are producing in the tumors tissue.
  • If there is no possibility of treatment with surgical intervention for tumors of the liver, kidneys or lungs, the tumor is reached with a needle and dried up with a special energy application (radio frequency, microwaves, etc.)
  • Visualized interventions and pain control procedures in patients with cancer, through a segmental denervation procedure. Surgical denervation of an area means blocking nerve connections that cause pain.

Special Interventional Percutaneous Treatments With the Needle

  • Does not require long hospitalization and patients are often discharged after a short observation.
  • Removal of any abscesses and deposits of fluid formed in the abdominal cavity or chest cavity from the skin using special devices.
  • Draining kidney cysts from the skin (abscess drainage).
  • Percutaneous drainage of kidney cysts (Renal abscess drainage).
  • Percutaneous nephrostomy and antegrade ureteral stenting, for draining urine from the inside of the skin by the catheter, in kidney and urinary tract obstructions to prevent damaging the kidney.
  • In case of liver, biliary tract or pancreatic diseases, in case of biliary tract obstruction, discharge of bile from the skin to prevent damage to the body or opening the obstruction with balloon and stent.
  • Especially parasitic (hydatide) cysts are removed from the liver by percutaneous
  • With Percutaneous Biopsy procedures, accompanied by imaging to understand the structure of tumors, nodules, masses, it is possible to perform precise needle punctures into different organs, to take obtaine samples for analysis.

Interventional radiology is a rapidly developing medical sub-specialty of radiology.

Interventional radiologists assist other clinical branches on many issues by performing percutaneous treatment using minimally invasive imaging-driven techniques. Recently, the possibilities for various radiological studies have expanded significantly. Thus, interventional treatment of more critical and intact patients has become possible. Surgery in interventional radiology is much less invasive than surgery with imaging. As a rule, these procedures are easier for patients, since there are no large incisions, the procedures are performed with less pain, risk and a shorter recovery time. Interventional radiologists plan an operation on previously acquired images. Then they direct the catheters through the vessels or percutaneously under visual control (digital substrate angiography, fluoroscopy, ultrasound, computed tomography). These procedures are performed under local or general anesthesia as needed.

Interventional radiological procedures are divided into two large groups: vascular and non-vascular interventions. Vascular interventions are also divided into neurovascular interventions (associated with vessels of the brain) and peripheral vascular interventions (associated with vessels of organs outside the brain).

The most common procedure among vascular interventional radiological procedures is classical diagnostic angiography. However, the most important part is intervention surgery using angiographic techniques. They usually include opening of narrowed or blocked vessels (balloon angioplasty (PTA), stenting, dissolution / removal of a clot) or closing of diseased vessels (embolization). However, in addition to them, various therapeutic procedures performed intravenously are used.

Balloon angioplasty and stenting procedures are the process of penetrating through a vein into the lumen of a blocked vessel, a narrowed artery or vascular glomeruli using balloon catheters or stents (metal nets). This type of treatment, performed by interventional radiologists, is used for all blood vessels except heart vessels. They can be classified as vessels of the kidneys and other internal organs, veins leading to the arms or legs, and vessels of the brain. Currently, intravascular treatment of even very thin vessels, such as veins under the knee, is carried out with great success.

Embolization processes are the process of blocking aneurysm (vasodilation), arteriovenous malformation (abnormal vascular bundle), intravenous and / or skin tumor or bleeding lesion. The most critical of these are the procedures performed in the brain vessels. Brain vascular diseases, which were previously treated with brain surgeries, are now treated by interventional radiology physicians with specially produced materials inside the vein with the closed method.

There are some special embolization processes used in cancer patients,  as “chemoembolization” or “radioembolization”. With “chemoembolization”, the region in which the cancer is located is reached through the vein and a cure for the cancer, as well as a substance that blocks the vein, is administered. In “radioembolization”, the area where the cancer is located is reached via vascular route and radiation emitting substances are given only for intra-tumor radiation treatment. These procedures are usually applied to liver tumors.

Dilatation of the aortic vein, which can be fatal, called an aneurysm. These diseases used to be treated with operations performed by opening the whole abdomen. However, nowadays, interventional radiologists are treating this type of diseased vascular enlargement with specially coated stents only by entering through the groin or armpit vein. In some cases, these operations can be performed as a team with cardiovascular surgeons.

It is very important to provide patients with appropriate vascular access in cases where medications should be administered through temporary or permanent vascular access (e.g. chemotherapy), or in cases where a large volume of blood exchange (e.g. dialysis) is required.

The installation of a port catheter in cancer patients and a hemodialysis catheter in dialysis patients provide this constant vascular access. Performing these procedures using interventional radiological imaging devices increases success and reduces risk.

In addition to the introduction of a catheter for hemodialysis in patients on dialysis, various procedures are performed in interventional radiology. The dialysis fistula opened in these patients is vital to them.The number and type of vessels with which you can open the fistula in patients are relatively constant. On the other hand, these fistulas have a certain shelf life. The main goal is to maximize the life of each fistula in these patients.

These fistulas can narrow over time, clots can form around them, and problems such as blood clots sticking together can occur. A significant part of these problems can be solved with the help of interventional radiological interventions. Another procedure in interventional radiology is associated with the treatment of varicose veins of the legs. Varicose veins in the legs are treated with laser cauterization using ultrasound picture. Thus, patients get rid of surgical intervention and having to stay in the hospital.

Another serious problem that can occur in the veins of the legs is a common thickening. This is called “deep vein thrombosis (DVT)”. Although dissolving clots with blood-thinning drugs is sufficient in most cases, blood-thinning drugs may not be enough in case of intense clot formation. In this case, the clot should be cleaned by intervention. Applying for help in time, you can completely clear the clot with the radiological intervention.

Interventional radiology is the second major group among procedures for non-vascular organs. Nonvascular interventional radiological procedures for diagnostic purposes are biopsy performed with imaging methods. Biopsies is the process of taking parts from organs such as thyroid, prostate, liver, pancreas, lung, kidney or other tumoral formations with the help of imaging methods such as ultrasound or tomography. Pieces are takening by placing a long needle in the desired tissue. Taking a biopsy is a procedure that is carried out in order to reach a definitive diagnosis in many diseases and therefore is of great importance in guiding the treatment.

Therapeutic nonvascular (related to non-vascular organs) interventional radiological procedures are very diverse according to different anatomical regions and diseases; It includes fluid drains such as abscess / cyst treatments, catheter interventions for kidney or bile ducts, and tumor burning procedures such as radiofrequency or microwave ablation. Fluid cysts can be drained and treated by penetrating the skin with special needles and placing catheters there. With this method, diseases such as kidney cysts, hydatid cysts, which can only be treated with surgical methods, can be easily eliminated.

In tumors, radiofrequency or microwave energies are transmitted to the diseased area with a needle, accompanied by imaging, creating high temperature, in other words, the tumor is eliminated by burning. This method is especially used in the treatment of liver tumors. However, it is a method that can potentially be used in many tumors.