302 Interventional radiology Flashcards
What is interventional radiology?
Image guided diagnostic or therapeutic procedure
Eg. pinhole vs keyhole surgery
How do you prepare a patient for interventional radiology?
Consent
NBM
Antibiotic prophylaxis?
Coagulopathy?
INR <1.5, platelets > 50-80,000 (N >150,000)
Monitoring
Pulse oximetry, BP, ECG
Oxygen
IV sedation/analgesia
Midazolam, pethidine, fentanyl
General anaesthesia
What is aortic transection?
When the aorta ruptures or tears
10-20% of fatalities from high speed RTA’s
Only 10-23% make it to hospital and if undiagnosed/untreated, 30% are fatal in 6hrs and 40% in 24hrs.
90% of patients who survive have tears at the isthmus
What is embolisation?
Artificial formation of an embolus
When is embolisation used?
-Traumatic bleeding
Eg. Internal iliac artery bleeding from pelvic trauma, Solid organ injury
-Post Partum Haemorrhage
-GI bleeds
What is TAE?
AKA transarterial embolization
When the blood supply to a tumor or an abnormal area of tissue is blocked
During TAE, a small incision is made in the inner thigh and a catheter is inserted and guided into an artery near the tumor or abnormal tissue
Name some embolic agents used in TAE
-Permanent
Coils – fibred, microcoils, Nestor, Spirale, MReye
PVA – 50-1000μ
Microspheres
Cyanoacrylate (‘glue’)
Onyx
Alcohol
-Temporary
Gelatin sponge
How is kidney injury graded?
Grade 1: contusion/ subcapsular haematoma
Grade 2: Laceration <1cm deep
Grade 3: laceration >1cm
Grade 4: Laceration extending through renal cortex
Grade 5: Shattered kidney, devascularised kidney
What is TACE?
AKA: Trans arterial chemoembolisation
It gives high doses of chemotherapy to the tumour in the liver and blocks off the blood supply
What are percutaneous ablation techniques?
Less invasive techniques that destroy tumours
Eg.
PEI (percutaneous ethanol injection)
RFA (radiofrequency ablation)
Laser interstitial hyperthermia
Cryotherapy ablation
Microwave ablation
Focussed ultrasound
