The fastest advancing science in clinical medicine
This website is being designed as an educational portal for patients and clinicians to update on aspects of the fast advancing science of diagnostic imaging and image guided minimally invasive therapies, also known as interventional radiology. Over the next few months we will add pages to show and illustrate procedures, download information, review evidence and upload presentations on this fast moving subject that has now become central to modern medicine. Please come back and visit the site over the coming months as it develops.
Introduction
Image guided surgery (Interventional radiology) is a subject that specialize in minimally invasive, targeted treatments. These physicians offer the most in-depth knowledge of the least invasive treatments available coupled with diagnostic and clinical experience across all specialties. They use X-ray, MRI, CT and other imaging to advance a catheter or needle in the body, such as in an artery, nerve or a tumour, to treat at the source of the disease internally. As the inventors of angioplasty and the catheter-delivered stent, which were first used in the legs to treat arterial disease in the leg, interventional radiologists pioneered minimally invasive modern medicine.
Today, interventional oncology is a growing specialty area of interventional radiology. Interventional radiologists can deliver various treatments for cancer directly to the tumor without significant side effects or damage to nearby normal tissue.
Interventional pain management offers needle based treatments to various conditions that can avoid more debilitating surgery
Image guided needle or catheter based therapies occupy a central position in most advanced hospitals, catering to almost all clinical specialities (see figure). Many conditions that once required surgery can be treated less invasively by interventional radiologists. These treatments offer less risk, less pain and less recovery time compared to open surgery. Conditions like liver cancer, uterine fibroids, bleeding control, arterial blocks, varicose veins, back pain, to name a few can now be managed by these techniques by equivalent effectiveness compared to more invasive surgeries. The future of targeted therapies, gene therapy and nanomedicine etc revolve around techniques deliverable by image guided therapies.
Conditions that can be treated:
Most uterine fibroids
Rest pain and claudication
Ischaemic diabetic foot
Varicose veins
Male varicocele and pelvic congestion syndrome
Benign prostatic hyperplasia
Recurrent haemoptysis, GI bleeds
Back pain including vertebroplasty and nucleoplasty
Curative treatment for small kidney, lung or liver tumours
Local control for larger tumours
Venous access and ports
Renal dialysis access
Bile duct and ureteric blocks
Complications of portal hypertension
&
Many more.
Interventional techniques:
Embolisation: Catheter based technique using coils, particles or glue to block tumour vessels or acute bleeding.
Chemoembolisation: As above but using local targeted high dose chemotherapy to treat tumours.
Ablation: Needle or catheter based technique using thermal energy forms like radiofrequency, microwave or cryo to treat tumours or varicose veins.
Balloons and stents: Techniques to open up a blocked tube like a artery, vein, bile duct, ureter, colon or oesophagus.
Needle biopsy and drainage: Core biopsy for pathological sampling or for draining thoraco-abdominal collections and abscesses.
Other techniques: Clot retrieval or lysis, caval filters, aneurysm stents, sclerotherapy etc.
Advantages:
Day case or short admission procedures
Less/ no pain
More cosmetic - pinhole/ spot dressing surgery
Less morbidity / complications
More rapid return to work
**Does not close the door for conventional surgeries**
**Can be combined with other treatments like chemotherapy or radiotherapy**.
About the author
Dr Shuvro Roy-Choudhury, FRCS, FRCR, FCIRSE
After completing his surgical training and FRCS, he trained in Radiology in Yorkshire before completing a Fellowship in Interventional Radiology in Guy�s and St Thomas Hospital in London under the supervision of Professor Andreas Adam, now the President of the Royal College of Radiologists. He has recently been awarded the European Board and Fellowship. He has worked as a senior Consultant in a leading teaching hospital in the UK since 2004.
Active in research and teaching, Dr Roy-Choudhury has over 25 peer reviewed publications, over 70 scientific presentations and has contributed chapters in 5 textbooks. He set up and ran the first tumour ablation service in the Midlands (UK) and was the author of the first European paper on kidney ablation. Research areas include tumour ablation, rectal cancer, perianal fistulae, GI bleeding, CT Colonography, pelvic floor etc. He lectures widely and is an invited faculty in several British (ACPGBI, BSIR), Indian (IRIA, ARSCICON) and European meetings in Surgery and Radiology and serves as a reviewer for several European journals.
He can be contacted for consultations every Tuesday evenings on 00913340212828, or, at Fortis Hospitals in Kolkata on 00913366284120.
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