INTERVENTIONAL RADIOLOGY

BASIC ANGIOGRAPHY

ARTERIAL ANGIOPLASTY/STENTING

• Carotid, vertebral, innominate, subclavian, aorta, renal, mesenteric, iliac, femoral, tibial, grafts, etc.

ARTERIAL ATHERECTOMY

• SilverHawk™ atherectomy device used
• For treatment of long segment superficial femoral artery occlusions and disease
• For treatment of occluded tibial arteries for limb salvage

TREATMENT OF ABDOMINALORTIC ANEURYSMS WITH ENDOGRAFT PLACEMENT VIA THE GROIN

VENOUS ANGIOPLASTY/STENTING

• SVC, Brachiocephalic, subclavian, IVC, iliac, etc.

TIPS (TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT)

• Treatment of symptomatic portal hypertension with variceal hemorrhage and/or refractory ascites

TRANSCATHETER ARTERIAL EMBOLIZATION

• Uncontrolled bleeding:
  • Bronchial artery of severe hemoptysis
  • OB related hemorage
  • Traumatic injuries-liver, spleen, kidneys, pelvis, etc.
  • GI bleeding
  • Severe epistaxis
  • Bleeding from neoplastic or dysplastic lesions
• Treatment of vascular malformations:
  • Pulmonary AVM's, etc.
• Preoperative devascularization to minimize blood loss:
  • Metastatic bone lesions, renal cell carcinoma, obstetric, spleen,etc.
• Uterine artery embolization for treatment of fibroids
• Treatment of testicular varicoceles
• Treatment of female pelvic congestion syndrome
• Chemoembolization of liver tumors

SELECTIVE THROMBOLYTIC THERAPY

• DVT thrombolysis of lower extremity: for prevention of post-thrombotic syndrome as well as for symptomatic relief
• DVT thrombolysis of upper extremity: therapeutic for arm swelling and pain
• Ischemic leg
• Thrombosed bypass grafts
• Thrombosed hemodialysis grafts
• Thrombolysis in the acute stoke patient

VASCULAR ACCESS

• Performed with imaging guidance
• PICC lines, central lines, vascaths
• Long term (tunneled) hemodialysis catheters

HEMODIALYSIS ACCESS MANAGEMENT

• Declotting of thrombosed grafts and fistulae
• Angioplasty/stenting of anastomotic graft stenoses
• Placement of temporary and long term (tunneled) hemodialysis catheters

ONCOLOGIC INTERVENTION

• Radiofrequency ablation of tumors: liver, lungs, kidney, etc.
• Chemoembolization of liver tumors: hepatoma, metastatic lesions from colon, neuroendocrine, etc.

ESOPHAGAL STENTING

• For severe inoperable malignant strictures
• Treatment of esophagorespiratory fisula

TRACHEAL/BRONCHIAL STENTING

• Treatment of mmalignant strictures

BILIARY STENTING

• Placement of metallic stent for treatment of malignant strictures

GU INTERVENTION

• Percutaneous nephrostomy tube placement
• Antegrade ureteral stent placement
• Percutaneous nephrostolithostomy with large stone fragmentation and removal preformed with urologist
• Renel cyst aspiration and ablation
• Percutaneous suprapubic bladder drainage tube placement using ultrasound guidance
• Biopsy

BILIARY PROCEDURES

• Percutaneous cholecystostomy - severly ill patients with cholecystitis
• Percutaneous transhepatic biliary drainage
• Transcatheter bile duct biopsy
• Biliary stone extraction
• Biliary metallic stenting - malignant stricture

IVC FILTER PLACEMENT

• Prevention of pulmonary embolism when indicated
• Placement of TEMPORARY IVC FILTER: for temporary protection (i.e. ortho patient with history of DVT undergoing surgery): filter removed via transchaeter techniques in 10-14 days

BALLOON KYPHOPLASTY

• For treatment of vertebral compression fractures

COLONIC STENTING

• For acute colonic obstruction - willl allow for evacuation and bowel cleansing so that a colostomy can be avoided after surgery

TREATMENT OF VARICOSE VEINS

• In patients with severe symptomatic varicose veins with ultrasound documentation of saphenous reflux disease as the source

INFERTILITY

• Hysterosalpingography
• Fallopian tube recanalization
• Varicocele embolization in male

GASTROSTOMY TUBE REPLACEMENT

• Percutaneous placement in the difficult patient using imaging guidance

TRANSJUGULAR LIVER BIOPSY

• For patients with generalized liver disease who are coagulopathic (percutaneous biopsy contraindicated)

IMAGE GUIDED BIOPSIES

• Thyroid, lung, liver, renal, adrenal, bone, soft tissue, peritoneal/retroperitoneal, pelvic, etc.

ABSCESS AND FLUID COLLECTION DRAINAGES

• Image guided aspiration or drainage tube placement
• Thhoracentesis/paracentesis

CHEST TUBE PLACEMENT

• Placement of pigtail chest tubes using imaging guidance
• Treatment of Pleural effusions, empyema, pneumothorax, etc.

ORTHOPAEDIC MEDICINAL THERAPEUTIC INJECTIONS

• Image guided SI joint injections
• Fluoroscopic guided hip joint injection

TREATMENT OF ARTERIAL PSEUDOANEURYSMS

• Ultrasound guided injection of post-cath arterial pseudoaneurysms with thrombin