Interventional radiography

Question 1

What is interventional radiography?

Answer 1

The treatment of pathological processes using image guidance

Vascular
-endovasular (catheter based) treatment, “interventional angiography”

non-vascular

• biopsies
• pain management through facet joint injections
• percutaneous tube insertions, “interventional fluoroscopy”

Question 2

Interventional radiography

• Designed to…
• Basic techniques
• Relies on..

Answer 2

• Designed to diagnose the disease, and intervene the disease process.
• Basic techniques are to open things up (angioplasty) and to shut things down (embolisation –> block bleeding blood vessels, or vessels supplying blood to tumour)
• Relies on visualisation of structures through CM

Question 3

CIN

Answer 3

• Renal function measured by serum creatinine levels, normal are 100-110micro mol/L
• CIN is defined as 25% increase in serum creatinine levels

Question 4

Embolisation

Answer 4

Embolisation agent: A substance used to occlude or drastically reduce blood flow in a vessel 
Examples are
-Coils (embolise saccular aneurysms)
-onyx
-PVA particles
-Gelfoam

Question 5

Angioplasty and stenting

Answer 5

Angioplasty: Dilating or opening a narrow vessel lumen to improve distal blood flow

Stenting: Intraluminal insertion of a metallic cage to maintain vessel patency

Indications (stenting)

• flow limiting disection
• traumatic rupture
• intracranial aneurysms (combined with coils)

Covered stent: Allows blood to pass through stent but not through stent wall
uncovered stent: Allows blood to flow in and around the stent

Question 6

Bleeding embolisation - pelvic trauma

Answer 6

Embolisation rationale

• Moderate bleeding: distal selective embolisation
• profuse bleeding: Proximal internal iliac artery embolisation, straight to theatre