Interventional Radiology

Interventional radiology is a sub-branch or higher specialty of radiology, which is the science of medical imaging, which is mostly directed to the treatment of diseases using imaging methods. The interventional radiologist does not only diagnose, but also plays a role in the treatment of diseases.

It is used in the treatment of many diseases from head to toe. Since this method, which is used as an alternative to surgery in cases where surgery is technically not possible or when the patient cannot handle the surgery, has proven itself clearly over the years compared to surgery, there are also treatment areas where it is given priority over surgery.

• The common feature of the treatments is that they are performed with imaging guidance through the needle hole without any incision or stitch.
• Except for neuroradiological treatments, most of the treatments in interventional radiology can be applied without the need for general anesthesia. However, patient comfort is tried to be kept at maximum with sedation and local anesthesia.
• In most procedures, the patient is discharged home on the same day.
• Risks are less compared to surgery.
• The time to return to normal life and working life is much shorter.

The main disease group in interventional neuroradiology is vascular diseases of the brain. Among these, aneurysm (bubble) treatments come first. In addition, “vascular tangles” called arteriovenous malformation (AVM) are among the diseases that contribute to the treatment. In cases where medicine and surgery are not preferred in the cerebral and neck vessels, especially in carotid stenosis, it would be much more appropriate for a neuroradiologist to perform this treatment. Some suitable brain and head-neck tumors are used to block the vessels feeding the tumors.

One of the most important treatment areas of interventional neuroradiology is acute stroke treatment. In this case, which means sudden congestion in the brain vessels, the brain tissue can be saved with timely intervention and paralysis or other obstacles can be prevented for the rest of the patient’s life.

Interventional Radiology Applications

Diagnostic Applications

Biopsies

Fine needle aspiration biopsies or Tru-cut biopsies accompanied by various radiological imaging techniques (Ultrasonography and/or Computed Tomography) for;

• Neck masses and Thyroid nodules
• Thoracic masses
• Abdominal organ biopsies (liver, pancreas, kidney)
• Bone biopsies are applied.

Interventional Radiology Applications

Diagnostic Applications

Biopsies

Fine needle aspiration biopsies or Tru-cut biopsies accompanied by various radiological imaging techniques (Ultrasonography and/or Computed Tomography) for;

• Neck masses and Thyroid nodules
• Thoracic masses
• Abdominal organ biopsies (liver, pancreas, kidney)
• Bone biopsies are applied.

• Superior and inferior venacavagraphy
• Pulmonary angiography
• Kidney venogram, Adrenal glands venography
• Upper / lower limb venography

Inferior Venacavagram: Inferior vena cava structures, tumor blockages and causes of thrombus are revealed.

Renal Venogram: Thrombosis in renal veins is investigated.

Adrenal Venography: It is done to view adrenal gland tumors.

Leg Venography: Deep veins of the leg and abdomen are investigated for thrombosis.

Saphenous Vein Venography: It is performed to evaluate the saphenous vein used as a graft before by-pass.

• Thoracentesis
• Abscess drains
• Stent applications in tracheobronchial strictures

• Bile duct interventions (biliary PTC, biliary drainage, biliary stenting)
• Placement of a stent in the bile ducts,
• Drainage of kidney cysts and abscess collections,
• RF Ablations
• Percutaneous nephrostomy,
• Abscess and collection drainage
• Antegrade ureteral stent,
• Biliary Stenting
• Kidney Interventions

Treatment of all body vascular stenosis with balloons and stents,

• Carotid Angioplasty and Stenting
• Intracranial stent application
• Subclavian and Vertebral artery stenting
• Renal Artery Angioplasty and Stenting
• Mesenteric Artery Angioplasty
• Iliac, Femoral artery and Popliteal artery angioplasty
• Intracranial aneurysm and embolization of arteriovenous malformations (AVM),
• Intra-arterial thrombolysis in cases of stroke
• Caroticocavernous fistula embolization
• Epistaxis, hemoptysis, embolization in acute gastrointestinal haemorrhages
• Aortic Aneurysm endograft applications
• Cranial and Neck Tumor Embolizations

Thrombotic occlusion of the main cerebral arteries may be the cause in cases of acute stroke. Such pathologies can be treated within a certain time limit.

Anterior and posterior circulation aneurysms can be embolized with direct coil or balloon modeling.

AVM and AVF pathologies can be embolized using various embolizing agents.

Patient symptoms can be relieved by providing peripheral artery stenosis and occlusion, balloon and stenting, and patency of the arteries.

With the application of covered stents, aneurysms in the thoracic and abdominal aorta, and false aneurysms that develop in the femoral and other arteries can also be treated.

In the treatment of hypertension, renal artery stenoses can be treated with stents and balloons, and their patency can be achieved.

In the treatment of hepatocellular carcinomas, the patient’s survival can be extended with intra-arterial chemoembolization. Embolization is an important alternative to surgery in the treatment of uterine fibroids.

• a) Angioplasty and stenting of venous strictures
• b) Placement of hemodialysis catheter
• c) Treatment of hemodialysis fistula stenosis with angioplasty
• d) Placement of filter in Vena Cava Inferior
• e) TIPS
• f) Uterine fibroid embolization
• g) Venous catheter placement

Stenosis in the foot vessels of diabetic patients can be treated with balloon and laser angioplasty and good results are obtained.

• Venous Port Placement
• Placement of permanent tunnel and temporary venous catheter
• In liver tumors
• RF ablation
• Transarterial chemoembolization
• Portal vein interventions