Interventional radiology

Interventional radiology is a relatively young branch of diagnostic radiology ( and in contrast to the Anglo-Saxon countries, it is in Germany still part of the diagnostic radiology) and represents the therapeutic arm of the multiple diagnostic radiology dar. In the interventional radiology are image control (ultrasound, CT, MRI and angiography) therapeutic interventions, for example in the vascular (eg, peripheral vascular disease) and biliary system (eg neoplastic occlusion of the bile duct system) and in parenchymal organs (eg, radiofrequency ablation of liver metastases) made.

History

After radiologists learned to represent the vasculature of the people by means of specific angiographic catheters, it was the idea of ​​vascular disease by balloon dilation or metallic vascular endoprostheses (called stents) via the same route to treat. Thus developed by the preparatory work of Sven- Ivar Seldinger (1921-1998), Charles T. Dotter (1920-1985) and W. Porstmann (1921-1982), especially Eberhard Zeitler (1930-2011) and Andreas R. Grüntzig ( 1939-1985) interventional radiology world to a minimally invasive treatment option for cardiovascular disease. The interventional radiology then expanded its range from the treatment of complex medical conditions ( eg, treatment of portal hypertension due to cirrhosis of the liver by means of the installation of a TIPS) and on the treatment of tumor diseases. Interventional radiology is acting almost always in close cooperation with colleagues from the fields of anesthesiology, surgery and internal medicine.

Treatment methods

Frequent intervention Radiological interventions are:

  • Angioplasty: recanalization of occluded vessels by balloon dilation and / or stent. Has since been adopted by the interventional cardiologists and neuroradiologists emerged a division of labor: cardiologists provide the cardiovascular, neuro- radiologists brain welfare providers and intracranial vessels and interventional radiologists all peripheral vessels (including mesenteric and retroperitoneal vessels such as hepatic and renal vessels ) of man.
  • Aortic: endovascular stent graft to the internal elimination of an aortic aneurysm
  • Venous filters: metal filters that are placed in the inferior vena cava, passager or permanent leave to prevent a pulmonary embolism at a thrombosis of the pelvic and leg veins.
  • Chemoembolization: A non- surgical treatment of malignant liver tumors: Tumorversorgende vessels are probed with a catheter under fluoroscopy and then applied a chemotherapeutic agent. The vessel is then closed by means of embolization. The latter increases the blood supply to the tumor and provides a retention of the chemotherapeutic agent in tumor tissue.
  • Embolization: closing a vessel to a malignant or benign tumor to treat or stop internal bleeding (eg uterine fibroids ). There are various Embolisate, ie, materials that are injected through an angiographic catheter to the target vessel and are in a position to close the vessel alcohol, gelatin particles, tissue adhesives ( Histoacryl, Ethibloc ), metal spirals (coils ), ethylene- vinyl alcohol copolymer ( EVOH), polyvinyl particles, polymer beads and Gelfoam.
  • System of a transjugular intrahepatic Porto -systemic stent - shunt (TIPS ) for the treatment of portal hypertension as a result of cirrhosis.
  • Thrombolysis: Emergency treatment method for reopening of thrombotic vessels sealed by means of instillation ( " injection" ) of clot- dissolving drugs ( urokinase, rTPA ) in thrombotic occluded vessels and / or mechanical damage (usually suction eg by means of the Venturi effect ) of the blood clot.
  • Venous Access: insert and supply special intravenous catheter systems (central venous catheter, Hickman catheter, subcutaneous port systems )
  • Cryoablation: Localized destruction of tumors by cold.
  • LITT: Laser Induced Thermal Therapy
  • Radiofrequency (RF / RFA): Localized destruction of tumors using heat.
  • Biopsy: image Controlled Tissue samples from all areas of the human body to position a histological diagnosis.
  • CT -controlled periradicular therapy: Therapy for radicular pain ( eg disc herniation )
  • Drainage system: Image guided system of drainage catheters for draining inflammatory and non - inflammatory fluids from the body.
  • Vertebroplasty: Percutaneous injection of bone cement for straightening broken vertebrae.
  • Biliary drainage: Diagnostic ( PTC) and interventional facility ( PTCD ) of catheters and endoprostheses (stents ) for the treatment of benign and malignant Gallenwegsstenosen.
  • Gastrostomy / gastrojejunostomy: Plant of nutrition catheters into the stomach or the small intestine.
  • Port catheter insert: minimally invasive insertion of a port-catheter system (usually in the Pektoralisloge below the collarbone with insert the catheter through the subclavian vein into the superior vena cava ) to the application of chemotherapy.
Transjugular intrahepatic portosystemic shunt Cerebral circulation Inferior vena cava filter Transcatheter arterial chemoembolization Percutaneous vertebroplasty
415287
de