Radiodiagnosis
Interventional Radiology
Interventional radiology for MBBS and NEET-PG: Seldinger technique, angioplasty, embolisation for bleeding and fibroids, drainage, nephrostomy and biopsy, mapped to NMC code RD1.9.
MedNext Academy | 3 min read
Interventional Radiology
Interventional radiology for MBBS and NEET-PG: Seldinger technique, angioplasty, embolisation for bleeding and fibroids, drainage, nephrostomy and biopsy, mapped to NMC code RD1.9.
This chapter describes the role of interventional radiology in common clinical conditions. It teaches the image-guided, minimally invasive approach, from the Seldinger technique and angioplasty to embolisation for bleeding and fibroids, percutaneous drainage and nephrostomy, and image-guided biopsy and vascular access.
High-yield: Interventional Radiology
- Interventional radiology uses image guidance to perform minimally invasive diagnostic and therapeutic procedures through small access points.
- The Seldinger technique establishes vascular access over a guidewire and underlies most angiographic and interventional procedures.
- Image guidance with fluoroscopy, ultrasound or CT allows needles, wires and catheters to be placed precisely and safely.
- Angioplasty and stenting reopen a stenosed or occluded artery, for example in peripheral arterial disease or renal artery stenosis.
- Transarterial embolisation controls bleeding, such as in trauma, postpartum haemorrhage or a bleeding peptic ulcer, by occluding the feeding vessel.
- Uterine artery embolisation is a uterus-sparing treatment for symptomatic fibroids.
- Transarterial chemoembolisation delivers chemotherapy and occludes the arterial supply of hepatocellular carcinoma.
- Percutaneous drainage under image guidance treats an abscess or a fluid collection without open surgery.
- Percutaneous nephrostomy relieves an obstructed, infected collecting system when urgent decompression is needed.
- Biliary drainage and stenting relieve obstructive jaundice caused by tumour or stones.
- An inferior vena cava filter prevents pulmonary embolism when anticoagulation is contraindicated or has failed.
- Image-guided biopsy obtains tissue from deep lesions with ultrasound or CT guidance and low complication rates.
- Central venous access, including tunnelled lines and ports, is placed under ultrasound and fluoroscopic guidance.
- The advantages of interventional radiology are smaller access, shorter recovery, local anaesthesia and lower morbidity than open surgery.
Common interventional procedures
- **Vascular access:** Seldinger technique over a guidewire underlies angiography and intervention.
- **Embolisation:** Controls bleeding, treats fibroids (uterine artery) and liver tumours (chemoembolisation).
- **Drainage:** Percutaneous abscess drainage, nephrostomy and biliary drainage relieve obstruction.
- **Advantages:** Smaller access, local anaesthesia, faster recovery, lower morbidity than open surgery.
NMC competencies in this chapter
- **RD1.9:** Role of interventional radiology in common clinical conditions
Frequently Asked Questions
What is the Seldinger technique?
It is the standard method of gaining vascular access, in which a needle punctures the vessel, a guidewire is passed through it, and a catheter is advanced over the wire, forming the basis of most interventional procedures.
What is embolisation used for?
Embolisation occludes a blood vessel to control bleeding in trauma or postpartum haemorrhage, to shrink uterine fibroids through uterine artery embolisation, or to treat liver tumours by chemoembolisation.
When is a percutaneous nephrostomy performed?
It is performed to decompress an obstructed collecting system urgently, particularly when the obstructed kidney is infected, providing drainage until the underlying cause can be treated.
Why is interventional radiology often preferred to surgery?
It achieves the goal through small access points under image guidance, usually with local anaesthesia, giving shorter recovery and lower morbidity than equivalent open operations in suitable patients.
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