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.
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