Interventional Radiology or Image Guided Surgery. What is it?

Interventional Radiology is also known as vascular interventional radiology. We all are aware regarding medicine specialty called as Radiology. Various modalities like X ray, ultrasonography, CT or MRI scan are done diagnosis of a ailment. DSA Digital Subtraction Angiography) which is used in Cath Lab is a part of Radiology too. For common people it’s a cardiologist who does Angiography, it stands true but that’s only for heart. What about other organs? What about other blood vessels? Besides heart there are arteries and veins to distribute blood for normal functioning. Interventional radiologist basically uses all these technologies to perform surgeries without taking any incision or by just making a pin hole.

Vascular procedures are performed in same Cath lab while CT scan and USG is commonly used to perform non vascular procedures. This is the reason that IR is also called as Image Guided Surgery.

Traditionally for internal bleeding the surgeon required to cut open the body or that particular part, to find the bleeder and then to treat it. Due to this advanced medical field the treatment has revolutionized. Interventional Radiologist would just pass small catheters which are small caliber tubes into blood vessels and detect the site of bleeding and stop it. This definitely helps unfit patients too for whom anesthesia cannot be administered for open surgery. During this non morbid IR surgery the patient stays awake and this is done under local anesthesia.

Blockage of vessels for which open surgery is very risky and can prove fatal has been taken over by IR. The thrombus or blockage can be treated in similar way by passing catheters. Blood thinner medicines are directly injected into the blockage (clot or thrombus), Thrombus is aspirated or a stent is deployed to relieve the block.

Endo Venous Laser Therapy (EVLT) for Varicose Veins is now a gold standard. It has replaced comples open surgery like stripping of veins. Very small caliber Laser Fibre is passed into the entire length of varicose veins under ultrasound guidance to treat it. Just a poin hole to be frank.

Treatment of cancer is changing every day. For inoperable tumours which are very large or advanced stage cancer where other treatment modalities like surgery, chemotherapy or radiotherapy becomes ineffective, IR plays an important role. If IR surgery is combined by chemotherapy and radiotherapy the response is much better and quicker.
Intra Arterial Chemo Embolization or Radio Frequency Ablation are the most effective techniques to downsize tumour and destroy it.

Trans Arterial therapy is one of the most effective mode of treatment for large inoperable tumours of liver, head, neck region and bone. In this the artery supplying the tumour is selectively cannulated with the specially designed catheters and chemotherapy drug is bombarded on the cancer. Along with this the blood supply to tumour is blocked. Gradually the tumour starts shrinking in size and also disappears. Inoperable cases can be operated. Patients can also be subjected to transplant with this. Side effects are minimal as less quantity of drug is injected as compared to routine chemotherapy.

Thermal Ablation (radio Frequency Ablation or Micorwave Ablation) gives results as if surgery has been performed. Under CT scan or USG guidance needle like device is inserted directly into tumours and tumour is destroyed by raising temperature above 100 degrees C. Any human tissue gets destroyed at 70 degrees C. The zone of ablation is controlled and can be precise. This modality is commonly used for tumours in liver, lung, kidney, bone etc.

Apart from Cancer patients do have sever pain and agony in abdomen or back (spine) which can be effectively treated with IR. Drug is injected into the nerve which stimulates pain. The result is immediate. Disease being advanced its difficult to treat pain. Patient do take narcotics which makes life miserable. Patient remain pain free after doing chemical ablation.

These are very few procedures which I could mention here. There are many more diseases and ways in which Interventional radiology has proven effective in treating disease and improving quality of life. All these surgeries are day care procedures done under local anesthesia.

Image Guided Surgery or Interventional Radiology is beneficial in various aspects of human life, in treatment vascular abnormalities, cancer, relieving pain and adjuvant in extending and improving human life.