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Encyclopedia > Interventional radiology

Interventional Radiology (abbreviated IR or sometimes IVR) is a subspecialty of radiology in which minimally invasive procedures are performed using image guidance. Some of these procedures are done for purely diagnostic purposes (e.g., angiograms), while others are done for treatment purposes (e.g., angioplasties). Pictures (images) are used to direct these procedures, which are usually done with needles or other tiny instruments like small tubes called catheters. The images provide road maps that allow the Interventional Radiologist to guide these instruments through the body to the areas of interest. This article focuses on radiology as a medical specialty. ... Catheter disassembled In medicine, a catheter is a tube that can be inserted into a body cavity duct or vessel. ...

Contents

History

The advancements in the field of radiological imaging such as the Seldinger technique, together with innovations in instrumentation, led to a rapid development in interventional procedures in the 1970s. Cardiovascular procedures were found to be particularly well-suited for guided and minimally invasive operations, and catheterization remains as one of the main applications for interventional radiology. The Seldinger technique is a medical procedure to obtain safe access to blood vessels and other hollow organs. ... A minimally invasive medical procedure is defined as one that is carried out by entering the body through the skin or through a body cavity or anatomical opening, but with the smallest damage possible to these structures. ...


Imaging methods

Common interventional imaging methods include X-ray fluoroscopy, computed tomography (CT), ultrasound (US), and magnetic resonance imaging (MRI). Fluoroscopy and computed tomography use ionizing radiation that may be potentially harmful to the patient and, in the case of fluoroscopy, the interventional radiologist. However, both methods have the advantages of being fast and geometrically accurate. Ultrasound suffers from image quality and tissue contrast problems, but is also fast and inexpensive. Magnetic resonance imaging provides superior tissue contrast, at the cost of being expensive and requiring specialized instruments that will not interact with the magnetic fields present in the imaging volume. In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... CT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around... Medical ultrasonography is an ultrasound-based imaging diagnostic technique used to visualize internal organs, their size, structure and their pathological lesions. ... This article or section does not cite its references or sources. ... Radiation hazard symbol. ...


Procedures

Common IR procedures are:

  • Angiography: imaging the blood vessels to look for abnormalities with the use of various contrast media, including iodinated contrast, gadolinium based agents, and CO2 gas.
  • Balloon angioplasty|stent: opening of narrow or blocked blood vessels using a balloon; may include placement of metallic stents as well (both self-expanding and balloon expandable).
  • Chemoembolization: delivering cancer treatment directly to a tumour through its blood supply, then using clot-inducing substances to block the artery, ensuring that the delivered chemotherapy is not "washed out" by continued blood flow.
  • Drain insertions: placement of tubes into different parts of the body to drain fluids (e.g., abscess drains to remove pus, pleural drains)
  • Embolization: blocking abnormal blood (artery) vessels (e.g., for the purpose of stopping bleeding) or organs (to stop the extra function e.g. embolization of the spleen for hypersplenism) including uterine artery embolization for percutaneous treatment of uterine fibroids. Various embolic agents are used, including alcohol, glue, metallic coils, poly-viny alcohol particles, embospheres, encapsulated chemo-microsphere, and gelfoam.
  • Thrombolysis: treatment aimed at dissolving blood clots (e.g., pulmonary emboli, leg vein thrombi, thrombosed hemodialysis accesses) with both pharmaceutical (TPA) and mechanical means
  • biopsy: taking of a tissue sample from the area of interest for pathological examination from a percutaneous or transjugular approach
  • Radiofrequency ablation (RF/RFA): localized destruction of tissue (e.g., tumours) by heating
  • Cryoablation - localized destruction of tissue by freezing
  • Venous access: insertion and management of specialized kinds of intravenous devices (IVs) (e.g. PICC lines, Hickman lines, subcutaneous ports including translumbar and transhepatic venous lines)
  • IVC filters: - metallic filters placed in the inferior vena cavae to prevent propagation of deep venous thrombus, both temporary and permanent.
  • Vertebroplasty: percutaneous injection of biocompatible bone cement inside fractured vertebrae
  • Nephrostomy/NUS placement: Placing a catheter directly into the kidney to drain urine in situations where normal flow of urine is obstructed. NUS catheters are nephroureteral stents which are placed through the ureter and into the bladder.
  • Gastrostomy/gastrojejunostomy tube placement: placement of a feeding tube percutaneously into the stomach and/or jejunum.
  • Dialysis access/intervention: Placement of tunneled hemodialysis catheters, peritoneal dialysis catheters, and revision/thrombolysis of poorly functioning surgically placed AV fistulas and grafts.
  • TIPS : Placement of a Transjugular Intrahepatic Porto-systemic Shunt (TIPS) for management of select patients with critical end-stage liver disease and portal hypertension
  • Biliary interventions - Placement of catheters in the biliary system to bypass biliary obstructions and decompress the biliary system. Also placement of permanent idwelling biliary stents.

Angiography or arteriography is a medical imaging technique in which an X-ray picture is taken to visualize the inner opening of blood filled structures, including arteries, veins and the heart chambers. ... Angioplasty is the mechanical, hydraulic dilation of a narrowed or totally obstructed arterial lumen, generally caused by atheroma (the lesion of atherosclerosis). ... Endoscopic view of a self-expandable metallic stent used to palliate an esophageal cancer A self-expandable metallic stent (or SEMS) is a metallic tube, or stent, used in order to hold open a structure in the gastrointestinal tract in order to allow the passage of food, chyme, stool, or... A non-surgical, minimally-invasive procedure involving selective occlusion of blood vessels by purposefully introducing emboli to treat such conditions as aneurysms, epistaxis, and uterine fibroids. ... Thrombolysis is the breakdown (lysis) by pharmacological means, of blood clots. ... A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Radiofrequency ablation (RFA) uses radiofrequency energy to destroy abnormal electrical pathways in heart tissue. ... Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ... An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... A peripherally inserted central catheter (PICC or PICC line) is a form of intravenous access that can be used for a prolonged period of time, e. ... A Hickman line in a leukemia patient. ... A Port-a-Cath® is a device for intravenous access in patients who require frequent or continuous administration of intravenous substances. ... An inferior vena cava filter, also IVC filter a type of vascular filter, is a medical device that is implanted into the inferior vena cava to prevent pulmonary emboli (PEs). ... Vertebroplasty is a medical procedure where bone cement is percutaneously injected into a fractured vertebra in order to stabilize it. ... In surgery, percutaneous pertains to any medical procedure where access to inner organs or other tissue is done via needle-puncture of the skin, rather than by using an open approach where inner organs or tissue are exposed (typically with the use of a scalpel). ... A diagram of a thoracic vertebra. ... TIPS is an acronym that can refer to: Terrorism Information and Prevention System Transjugular intrahepatic portosystemic shunt Treasury Inflation-Protected Securities TRIZ, Russian acronym for Teoriya Resheniya Izobreatatelskikh Zadatch (Theory of Inventive Problem Solving - TIPS) Training for Intervention Procedures by Servers of Alcohol To Insure Prompt Service This page expands...

References

  • Rösch J, Keller F, Kaufman J (2003). "The birth, early years, and future of interventional radiology.". J Vasc Interv Radiol 14 (7): 841-53. PMID 12847192.

External links


  Results from FactBites:
 
Interventional Radiology-University of Colorado Denver Health Sciences Center (196 words)
Interventional Radiology is minimally invasive surgery for the 21st century
Interventional Radiology is minimally invasive surgery performed with the use of image guidance (CT scans, ultrasounds, and x-rays).
Interventional Radiology is less invasive than standard surgery because procedures are performed through small (millimeters) incisions made in the skin and the procedures are performed with the use of small catheters or tubes placed through the skin into the blood vessels and internal organs.
Society Of Interventional Radiology - Patients and Public - What is interventional radiology? (809 words)
Interventional radiology procedures are an advance in medicine that often replace open surgical procedures.
Interventional radiologists (IRs) use their expertise in reading X-rays, ultrasound and other medical images to guide small instruments such as catheters (tubes that measure just a few millimeters in diameter) through the blood vessels or other pathways to treat disease percutaneously (through the skin).
Interventional radiologists invented angioplasty and the first catheter-delivered stent, what was first used in the legs, to save patients with vascular disease from amputation or other surgery.
  More results at FactBites »

 
 

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