Radiology 2: interventional radiology

Question 1

what is

IR?

Answer 1

image guided diagnostic or therapeutic procedure achieved through percutaenous puncture of a vessel or organ or via a body opening.

Question 2

what are the steps to preparing patients for IR?

Answer 2

consent 
NBM
antibiotic prophylaxis? 
caogulopathy 
INR<1.5 
monitoring 
oxygen 
general anaethestic very rare use.

Question 3

what equipment is used in IR?

Answer 3

puncture needles 
guidewire 
catheter 
balloons 
stents 
embolisation material

Question 4

what are the different types of balloon stents?

Answer 4

balloon expandable

self expanding

Question 5

how does haemorrhage lead to death?

Answer 5

hypovolaemic shock
leading to brain injury
late death from multi-organ failure

Question 6

what is embolisation used for?

Answer 6

Traumatic bleeding - solid organ injury and internal iliac artery bleeding from pelvic trauma.
post partum haemorrhage
GI bleeds

Question 7

what is the most common embolic agents?

Answer 7

1. Coils

2. particles

Question 8

what is the scale of renal trauma ?

Answer 8

Grade 1 - contusion
Grade 2 - laceration <1cm depth of renal cortex
Grade 3 - laceration >1cm into renal cortex
Grade 4 - laceration extending through renal cortex , medulla and collecting duct
grade 5 - shattered kidney

Question 9

how is IR used in the GI tract?

Answer 9

1. stent insertion - oesophageal, duodenal, colonic
2. balloon dilation - oesophagus
3. enteral feeding - gastrostomy, gastrojejunostomy

Question 10

how is IR used in the HPB

Answer 10

percutaenous transhepatic cholangiography

percutaenous transhepatic biliary drainage

biliary dilation and stenting

TIPS

liver tumour

Question 11

what are the 2 main types of percutaenous ablation techniques?

Answer 11

1. radio-frequency ablation

2. cryotherapy