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Intervention Lec 1 Theory

1) There are no absolute contraindications to interventional radiology procedures if done appropriately, but relative contraindications include coagulopathy, anticoagulant use, underlying infections or medical conditions affected by injectates. 2) Interventional radiology procedures are quicker and less invasive alternatives to surgery, allowing treatment of sicker patients with reduced risk, hospitalization time, and organ preservation. 3) Common interventional radiology procedures include angiography, angioplasty, stent placement, biopsies, drainages, embolization, and biliary, vascular, and non-vascular interventions under imaging guidance.

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Javeria Khan
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20 views

Intervention Lec 1 Theory

1) There are no absolute contraindications to interventional radiology procedures if done appropriately, but relative contraindications include coagulopathy, anticoagulant use, underlying infections or medical conditions affected by injectates. 2) Interventional radiology procedures are quicker and less invasive alternatives to surgery, allowing treatment of sicker patients with reduced risk, hospitalization time, and organ preservation. 3) Common interventional radiology procedures include angiography, angioplasty, stent placement, biopsies, drainages, embolization, and biliary, vascular, and non-vascular interventions under imaging guidance.

Uploaded by

Javeria Khan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Lecture No.

03 RT-SP-22

Interventional radiology (T)


Instructor: Javeria Khan

03/12/2024 1
Absolute contraindications
No absolute contraindications to the appropriate use of guided
procedures, general rules might apply,
Uncooperative patients
Known allergy to the injectate
Lack of appropriate equipment or skill to complete the
procedure
10/16/2023

2
Relative contraindications
Coagulopathy or anticoagulant/antiplatelet therapy/patient with
large liver metastases or cholestasis and other causes for liver
malfunction
Have an increased risk of bleeding complications
Underlying medical condition that may be affected by the
injectate( e.g. diabetes mellitus that may be affected by
corticosteroids)
Local infection, rash or skin breakdown

03/12/2024 3
Recommendations
INR< 1.5 and thrombocyte counts > 40,000 per microliter – A
generalized recommendation or go ahead values
If these labarotory criteria are not fulfilled and the procedure is
deemed critical to the patient care, administration of 3 portions of
thrombocytes or freshly frozen plasma to correct the coagulation
parameter in question is suggested.
The 3 portion should be administered as one before, one during and
one after the procedure.

03/12/2024 4
History:
1967, dr alexander margulis coined the phrase, “interventional diagnostic
radiology”
Mid 70’s: improved radiologic imaging and development of tools; balloons
catheter wires
Interventional radiologists pioneered coronary angiography, invented
angioplasty and catheters delivered stents
1992: AMA officially recognized IR as a medical specialty
2001: society of interventional radiology (SIR) adopted the following
definition: “interventional radiology is the medical spaciality devoting to
advancing patients care through the innovative integration of clinical and
imaging based diagnosis and minimally invasive procedures”
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Advantages:
Quicker
Able to do procedures in sick patients
Reduced risk
Outpatient and same day procedure
Versatility
Reduced hospitalization time
Preservation of organ function
Enhanced patient comfort
Precise image guidance
03/12/2024 6
Vascular Interventions
Angiography/Angioplasty/stents
Venous/arterial
Fibrinolytic therapies
Venous/arterial
Embolization techniques
IVC filter insertions
( mostly retrievable)

03/12/2024 7
Non-Vascular Interventions

Biliary interventions
Percutaneous cholangiography
and biliary drainage
catheter insertion
Cholecystectomy
Biliary stone removal
Biliary strictures: stent insertions

03/12/2024 8
Non-Vascular Interventions
GI interventions
Percutaneous gastrostomy
GI strictures

GU interventions
Antegrade pyelogram
Nephroureteral and ureteral stents
Renal stone manipulation

03/12/2024 9
Non-Vascular Interventions CT scan and
Ultrasound
Biopsy and/ or fluid aspirations
Thoracic( lung, pleural, mediastinal)
Retroperitoneal lymph nodes
Pancreas
Spleen
GI mesenteric
Adrenal
Peritoneal
Thyroid
Nuerospinal
03/12/2024 10
drainages
Abscess/infections
• Thorax
• Retroperitoneal
• Intraperitoneal
• superficial

03/12/2024 11
drainages
Non-infected
• Pleural(effusion, pneumothorax)
• Mediastinal
• Thorax
• Retroperitoneal
• Intraperitoneal
• superficial

03/12/2024 12
Intra-procedure care
Procedural sedation when indicated
Circulator for anesthesia cases
Monitor patient continuously during procedure
Report any abnormal changes in vitals sign or patient condition to
the interventional radiologist
Reassure patient, explain what will happen next
Reassess patient frequently for pain, change in condition and
intervene as approprite

03/12/2024 13
03/12/2024 14
post-procedure care
Post procedure instructions: patient, family member if procedural
sedation is used
Maintain IV assess until discharged
Monitor puncture site, wound, etc. until patient transferred to
nursing unit or discharged home
Reassess condition, vital signs, pain or above
Documents assessment and discharge criteria on flow sheet
Discharge instruction given to and reviewed with patient and family
member

03/12/2024 15
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