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Interventional Diagnostic Tips

Interventional Radiology - All You Need To Know About It!

MBBS ,MD ,DNB (Radiodiagnosis), Fellowship In Interventional Radiology
Radiologist, Mumbai
Interventional Radiology - All You Need To Know About It!

Interventional radiology is a subspecialty of radiology that involves targeted, minimally invasive treatments. Intervention radiologists use their knowledge of examining X-rays, ultrasound and medical images, to assist doctors in guiding instruments. Catheters and other medical instruments are thus guided to treat the condition.

Common Interventional Procedures-

  1. Angiography is an X-ray of the blood vessels. It helps diagnose any possible blockages or infections in the arteries and veins. It employs a catheter to introduce a contrast dye into the blood vessels to produce an X-ray image of them.
  2. Balloon Angioplasty is employed by interventional radiologists to open clogged arteries in different parts of the body. It inserts an extremely small balloon into the blood vessel and inflates it, thereby unblocking narrow and blocked blood vessels.
  3. Vertebroplasty is used to treat fractures and spinal column lesions. It provides rapid pain relief and protection from possible future fracture or damage.
  4. Varicocele embolization is used to treat enlarged blood vessels of the scrotum. These, if left untreated, might cause infertility and extreme pain.
  5. Uterine fibroid embolization shrinks enlarged, painful, benign tumors present in the uterus.
  6. Uterine artery embolization is used to control postpartum bleeding and helps prevent a hysterectomy.
  7. Stenting involves using a small mesh tube to open ducts which have been blocked and drain bile from the liver.
  8. Chemoembolization is used to deliver cancer-fighting agents directly to the cancerous tumor. This is the most advanced form of treatment for cancers affecting the endocrine system, melanoma, and liver cancer.

Advantages of Interventional Radiology
The many advantages of Interventional Radiology include-

  1. Minimally invasive- With the use of interventional radiology, surgical incisions can be kept small and extremely precise. The procedures which use these techniques are minimally invasive and do not tax the patient’s health.
  2. Less use of anesthesia- The use of general anesthesia is more often than not required in these procedures. This significantly reduces the possible complications that are associated with the use of anesthesia.
  3. Shorter Recovery period- Since these procedures are minimally invasive, the recovery period is extremely short. And the patient can return to his daily routine within a few days itself.
  4. Cost-efficient- These procedures are also less expensive than open surgeries, making them extremely cost-efficient.

Interventional Radiology is a fast developing area of medical science and provides multiple advantages that traditional medicine does not.

In case you have a concern or query you can always consult an expert & get answers to your questions!

4486 people found this helpful

Interventional Radiology - How It Can Help In Cancer Treatment?

Dr. Tegbir Singh Sidhu 86% (18 ratings)
MBBS, Diploma in Medical Radio Diagnosis (DMRD), MD
Radiologist, Mohali
Interventional Radiology - How It Can Help In Cancer Treatment?

With cancer on the rise, there is a constant search for ways to treat it without having to resort to surgery. One such discovery is interventional radiology (IR). This is a sub-specialty of radiology where minimally invasive techniques are used to diagnose and treat diseases in many organs.

Interventional radiology (IR) is used to:

  1. Manage pain and complications
  2. Perform biopsies
  3. Overall symptom management
  4. Manage metastatic disease

Features:

  1. Image-guided treatment
  2. Minimally invasive, so less pain and easy recovery
  3. Improved accuracy compared to an open surgical procedure

IR Procedures: Some of the common IR procedures performed to help manage cancer are listed below with brief descriptions.

  1. Ablation: Tumor ablation is a minimally invasive procedure that uses extremes of temperature. This procedure can be used to manage symptoms and to treat the tumor. Radiofrequency waves are commonly used and the target organs are lungs, liver, and spine.
  2. Chemoembolization: A minimally invasive approach, especially for deep-seated cancers such as liver. This involves delivering the chemotherapy directly into the artery which is feeding the cancer. The chemotherapy is also combined with blocking agents known as emboli, which improves the success rate of the attack on the cancer cells.
  3. Angiography: This procedure involves mapping the blood vessels. This can help identify abnormal enlargement or narrowing of vessels and blockages. This is done by injecting a dye into the blood vessels, which can then be imaged or viewed through an X-ray scanner.
  4. Biopsies: Thin needles are inserted into the affected organ to remove portions of tissue. This can help in confirming diagnosis, and in cases of very small lesions, even complete removal is possible.
  5. Pain management: Cancer is notorious for causing bone and joint pains as the growing tumor presses on the surrounding tissues. Where routine pain killers do not work, injections into the joint space are required. IR helps in this area by directing the injections into the appropriate spaces.
  6. Catheter placement: Where there is need for constant draining of fluids from cancers, IR is used for appropriate placement of catheters.
  7. Port placement: In patients who need to be given chemotherapy for prolonged periods, ports are placed which act as injection sites without the need for multiple pricks.

What can the patient expect?

  1. These are done as outpatient procedures, often in the morning
  2. Do not eat or drink in the morning
  3. Take your prescription medications with water alone
  4. Arrange for transport so you can return home as driving is not allowed
  5. Confirm any other specific instructions or advice with the lab performing this procedure.

The role of IR in managing cancer is only set to expand in the coming years. In case you have a concern or query you can always consult an expert & get answers to your questions!

3236 people found this helpful

Interventional Pain Management For Low Back Pain!

Dr. Ruchi Gupta 90% (79 ratings)
MD - Anaesthesiology, DNB, MBBS, Diploma In Aesthetic Medicine
Pain Management Specialist, Amritsar
Interventional Pain Management For Low Back Pain!

Chronic pain in the lower back is intolerable. Treating it with interventional pain medicine ensures you can have a pain-free life. The best part happens to be the multiple alternatives offered by this system and it does not recommend surgery. Chronic lower back pain disables more people than cancer or cardiovascular diseases. This not only affects the quality of life but can also lead to depression. Affected people cannot concentrate on career, and not all nature of jobs is apt for them.

Interventional pain medicine creates a program and routine for various treatments.

Facet injections: Diagnosis and pain relief are offered by facet injections. It diagnoses if the pain emanates from the facet joints of the spine. To identify this, a numbing medicine is injected in the facet joints of the spine. If these joints are where the pain originates, then you will be satisfied for the relief is instant. If the problem is severe, the relief is temporary and if the degeneration is mild, then the relief is long-lasting. The steroid cortisone with the numbing agent is injected, which helps in offering the pain-relieving effect. When only the numbing agent is injected, the pain relief is temporary. Using the steroids helps in bringing down the inflammation. This improves the quality of treatment. Facet blocks, as these facet injections are called, got this name because they block the facet pain. If you are not responding to the facet injections, radiofrequency rhizotomy is recommended.

Radiofrequency Rhizotomy: This advanced treatment helps in alleviating pain caused by progressive degeneration of the facet joints. The pain-sensing nerves in the facet joints are targeted in this treatment. A radiofrequency-generated heat is used to alleviate the pain. The key factor is that your doctor should be aware of the place of origin of your pain. To identify the right nerves, an MRI scan, discography, or facet injection might be used by your doctor. Lumbar discography comes into picture when patients do not respond to the other conventional treatment methods. You need to be awake and guide the radiologist when radiofrequency rhizotomy is performed. An electrode needle is used close to the facet joint that suffers degeneration. After the nerve is numbed with an anesthetic, this thin needle is used to apply heat. The connection between the brain and the nerve is cut down. During this treatment, the nerves above and below the affected nerves are targeted, in addition to the affected nerves. This ensures that no pain is caused even by the less damaged nerves in the future.

Lumbar epidural steroid injection: When the aforementioned treatments fail, Lumbar Epidural Steroid Injection, LESI in short, helps in pain relief by using steroids. The skin is numbed with an anesthetic and the steroids are injected. The targets are the dura and sac that contain the nerve roots. The injections are effective in offering results for a few months. Over a period of one year, three LESI injections can be given. The pain relief is excellent and you can do exercises and stretches after getting one injection. This is an excellent treatment for chronic back pain and sciatica.

Sacroiliac joint block: These are a type of injections that used for diagnosing as well as treating low back pain pertaining to sacroiliac joint dysfunction. It is the joint that is located right next to the spine which is connected from the bottom of the spine to the hip. Here in a needle is inserted in the sacroiliac joint to inject a numbing agent and an anti-inflammatory medicatiton. This injection is repeated thrice a year. Also, for best results the injection must be followed by a physical therapy. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

3555 people found this helpful

Diagnosing Peripheral Vascular Diseases With Interventional Radiology

MD - Radio Diagnosis/Radiology, MBBS, FNVIR
Radiologist, Mumbai
Diagnosing Peripheral Vascular Diseases With Interventional Radiology

Peripheral vascular disease (PVD) is a circulation issue that affects the veins and blood vessels outside of the brain and heart. PVD commonly strikes the veins that supply blood to the arms, legs, and organs situated beneath the stomach. These are the veins that are located away from the heart. They are known as peripheral vessels.

In PVD, the width of the veins get limited. Narrowing is normally created by arteriosclerosis. Arteriosclerosis is a condition where plaque develops inside a vessel. It is additionally called 'solidifying of the arteries'. Plaque acts towards reducing the amount of blood and oxygen that is supplied to the arms and legs. As the plaque development advances, clumps may develop, which may further affect the vessel.

There are two main types of PVDs:

  1. Functional PVD: This doesn't include physical issues in the veins. It causes accidental side effects. Typically,these fits happen suddenly.
  2. Organic PVD: This includes changes in the vein structure. This sort of PVD causes irritation, tissue harm, and blockages.

The most well-known reasons for functional PVDs are as follows:

  • Emotional stress
  • Smoking
  • Cold temperatures
  • Operating Vibrating machinery

The common causes of such natural PVDs are given below:

The symptoms include the following:

Diagnosis:

PVD can be diagnosed using interventional radiology (IR).

IRis a sub-claim of radiology that gives an image-guided diagnosis, and if required, includes treatment of the organs as well.It has developed as a first-line treatment in the administration of PVD.

Advantages:

IR medications are for the most part less demanding for patients than surgery, since they include no surgical cut.They are less painful and have shorter stays at the hospital. By and large, the patients are discharged on the same day the procedure is done. This mainly includes angioplasty and stenting. The procedure is as follows:

  • Utilising imaging for direction, the interventional radiologist puts a catheter through the femoral artery in the crotch to the blocked vein in the legs.
  • At that point, the interventional radiologist expands a balloon to open the vein that is blocked.
  • Sometimes it is opened with a tiny metallic cylinder called astent.
  • This is a treatment that does not require surgery; only a scratch in the skin the extent of a pencil tip.

Alternative measure:

Angioplasty and stenting have totally replaced invasive surgical methods. Early trials have proven IR to be as successful as surgery for some blood vessel and artery impairments. Earlier, extensive clinical experience demonstrated that stenting and angioplasty are favoured as first-line treatments for more procedures all through the body .

Doctors as well as patients who have been through the same, believe that IR is much better for PVD than invasive surgery, since it reduces the risk of infection.

4955 people found this helpful

Diagnostic Hysteroscopy - How Can It Be Of Help?

Dr. Pragnesh Shah 87% (121 ratings)
MD, MBBS
Gynaecologist, Ahmedabad
Diagnostic Hysteroscopy - How Can It Be Of Help?

Indications:

  1. Primary Infertility
  2. Secondary Infertility
  3. Investigating & treating a case of B.O.H.
  4. Investigating & treating Abnormal bleeding P/V
  5. Investigating & treating case of mass inside the uterine cavity

Objective:

Hysteroscopy is the commonest type of work up in the entire Infertility patient along with Diagnostic Laparoscopy. Only diagnostic hysteroscopy is the commonest work up recommended before IVF. We record Hysteroscopy diagnostic & operative procedure for future important record in Infertility patient, for second opinion & for deciding future treatment protocol. 

Benefits of Hysteroscopy Surgery:

  1. Shorter Hospital stay.
  2. Earlier return to your routine work.
  3. Cosmetically no scar on abdomen.
  4. Less pain after operation.
  5. Best fertility enhancement & Fertility results following hysteroscopy
  6. Video-live operative file available in CD/DVD for future reference (Transparency about surgical procedure).
  7. Patient discharged within 2-4 hours after procedure.
  8. Patient can resume to her normal routine work within 12-24 hours after the procedure.

Pre-operative Check Lists:

  1. Lab. Investigation for Surgery (Urine complete & Blood complete, HbsAg, HIV, R.B.S.Etc.); Pelvic Trance vaginal USG report.
  2. Specific Investigations for Infertility (Endocrine, Blood, Genetic, Husband’s Semen report etc. If The couple is infertile)
  3. Operation planned from 4th to 10th day of Menstrual Cycle.
  4. Preparation of local parts.
  5. No. Of Cuts on Abdomen: Nil 

Average Stay in Hospital:
2 to 4 hours. (DAY CARE SURGERY)

Average Duration of Surgery:
2 to 10 minutes

Average Blood loss during Surgery:
Negligible

Average time after operation to resume normal activities/work:
Within 12-24 hours.

Anesthesia:

General Anesthesia (Patient will not feel any pain in Operation Theatre during surgery)Procedure:Patient is given general anesthesia. Patient is put on lithotomy position. Local parts cleaning & paintings with antiseptic solution & draping are done. After P/V examination cervix is checked with uterine sound. For Diagnostic hysteroscopy after removing the air, hysteroscopy (varsascope/1.9 mm/ 2.9 mm Hysteroscopy along with irrigation of Normal saline is introduced inside the cavity. Systemically both corneal openings, cavity, both lateral walls and anterior & posterior wall of the uterine wall is noticed for any lesions or normalcy. For operative/therapeutic hysteroscopy cervix is dilated up to 7mm / 10 mm for introduction of Operating hysteroscopic sheath or resectoscope for operative hysteroscopy. Hysteroscopy requires dilatation of the uterine cavity to create working space inside the uterine cavity and flushes both fallopian tubes with high pressure fluid helps in achieving very good fertility enhancing results following Hysteroscopy in infertility patients. Addressing all the infertility related lesions like broad septum from the fundus, intra-uterine adhesions, polyps or tubal cannulation helps us in treating infertility patients in the same sitting
                        
Post-operative Course:

Patient remains drowsy/sedated for 1-2 hours after hysteroscopy but conscious & pain free. Patient can take fluids 1-2 hours after hysteroscopy & light food after 2-4 hours. She may feel little discomfort after hysteroscopy for 6-8 hours but it can be relieved with pain killer tabs. Most of the patients can walk normally without support and can take normal diet 6-8 hours after the hysteroscopy. She can be discharged on the same day of the operation. Few patients may feel nausea & vomiting after hysteroscopy, which can be very well controlled with injection in post-operative room. Patient can do her normal activity within 12-24 hours after hysteroscopy. Patient is advised to take antibiotics & analgesic tabs for 5 days following hysteroscopy. Patient is advised to report to doctor for severe pain or bleeding or fever in postoperative period (Day-1 to Day-5) immediately. Patient is advised to come for follow up 7 days after the next period or on the day for IVF protocol & preparation for IVF. In case you have a concern or query you can always consult an expert & get answers to your questions!

3819 people found this helpful

Diagnostic Tests Females

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Diagnostic Tests Females

Diagnostic Tests Females

We provide testing for fertility by all modalities ranging from reproductive hormones to diagnostic ultrasound to ascertain the cause. It is advisable that we make you undergo these tests before your final treatment/ plan of management is started.

  • Blood tests: These include a whole array of blood investigation ranging from CBC , Urine routine microscopy, RBS, TSH,PROLACTIN,VDRL,HIV,HBSAG,HCV,AMH. And any other test depending on the history of the couple.
  • Transvaginal ultrasound: A complete ultrasound of the uterus and adnexa is done to diagnose any anatomical disorder.
  • Specific tests: In cases of recurrent implantation failure and recurrent pregnancy loss or if required other tests are also advised.
  • Diagnostic Laparoscopy and Hysteroscopy: For many, this test is an important part of a fertility evaluation .Laparoscopy takes place under general anaesthesia with small incisions made at or just below the navel and the pubic hairline. A laparoscope (a small-diameter telescope) is passed through the incision, which enables one to view the ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities. We can check that the tubes are open (tubal patency) by injecting dye through the uterus and observing it spill or not through the ends of the fallopian tubes.
  • Hysteroscopy: uses another small-diameter telescope called a hysteroscope. This enables to assess the uterine cavity for abnormalities such as polyps, adhesions or fibroids.

Diagnostic Tests Males

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Diagnostic Tests Males

Diagnostic Tests Males

  • A basic semen analysis is the main test advised for all males .

  • If required we also go for quality semen analysis , sperm survival test .
  • Males suffering from more severe problems can also undergo DNA fragmentation test.
  • Blood tests like TSH , Prolactin, FSH,LH,Testosterone , SHBG ,HIV ,HCV,HBSAG,VDRL are also done.
  • If required Ultrasound of the Scrotum and Testes is also done.

 

1 person found this helpful

Diagnostic Tests- Females

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Diagnostic Tests- Females

Diagnostic tests- Females

We provide testing for fertility by all modalities ranging from reproductive hormones to diagnostic ultrasound to ascertain the cause. It is advisable that we make you undergo these tests before your final treatment/ plan of management is started.

  • Blood tests – These include a whole array of blood investigation ranging from CBC , Urine routine microscopy, RBS, TSH, PROLACTIN, VDRL, HIV, HBSAG, HCV, AMH. And any other test depending on the history of the couple.
  • Transvaginal ultrasound- A complete ultrasound of the uterus an adenexa is done to diagnose any anatomical disorder.
  • Specific tests – In cases of recurrent implantation failure and recurrent pregnancy loss or if required other tests are also advised.
  • Diagnostic Laparoscopy and Hysteroscopy – For many, this test is an important part of a fertility evaluation .Laparoscopy takes place under general anaesthesia with small incisions made at or just below the navel and the pubic hairline. A laparoscope (a small-diameter telescope) is passed through the incision, which enables one to view the ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities. We can check that the tubes are open (tubal patency) by injecting dye through the uterus and observing it spill or not through the ends of the fallopian tubes.

Hysteroscopy uses another small-diameter telescope called a hysteroscope. This enables to assess the uterine cavity for abnormalities such as polyps, adhesions or fibroids.

1 person found this helpful

Diagnostic tests- Females

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Diagnostic tests- Females

Diagnostic tests- Females

We provide testing for fertility by all modalities ranging from reproductive hormones to diagnostic ultrasound to ascertain the cause. It is advisable that we make you undergo these tests before your final treatment/ plan of management is started.

  • Blood tests – These include a whole array of blood investigation ranging from CBC , Urine routine microscopy, RBS, TSH, PROLACTIN, VDRL, HIV, HBSAG, HCV, AMH. And any other test depending on the history of the couple.
  • Transvaginal ultrasound- A complete ultrasound of the uterus an adenexa is done to diagnose any anatomical disorder.
  • Specific tests – In cases of recurrent implantation failure and recurrent pregnancy loss or if required other tests are also advised.
  • Diagnostic Laparoscopy and Hysteroscopy – For many, this test is an important part of a fertility evaluation .Laparoscopy takes place under general anaesthesia with small incisions made at or just below the navel and the pubic hairline. A laparoscope (a small-diameter telescope) is passed through the incision, which enables one to view the ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities. We can check that the tubes are open (tubal patency) by injecting dye through the uterus and observing it spill or not through the ends of the fallopian tubes.

Hysteroscopy uses another small-diameter telescope called a hysteroscope. This enables to assess the uterine cavity for abnormalities such as polyps, adhesions or fibroids.

Diagnostic Tests Males

Dr. Richika Sahay Shukla 92% (827 ratings)
DNB (Obstetrics and Gynecology), MBBS
IVF Specialist, Delhi
Diagnostic Tests Males

Diagnostic Tests Males:

  • A basic semen analysis is the main test advised for all males.

  • If required we also go for quality semen analysis , sperm survival test.
  • Males suffering from more severe problems can also undergo DNA fragmentation test.
  • Blood tests like TSH, Prolactin, FSH, LH, Testosterone, SHBG, HIV, HCV, HBSAG, VDRL are also done.
  • If required Ultrasound of the Scrotum and Testes is also done.
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