GI and hepatobiliary interventions:
- Embolization of bleeding vessels, either due to trauma or iatrogenic or due to pseudoaneurysms (for eg. post pancreatitis, post surgical or post ERCP sphincterotomy)
- Transjugular intrahepatic portosystemic shunt (TIPSS) in acute variceal haemorrhage or refractory ascites/hepatic hydrothorax in cirrhosis as a bridge to transplant or in Budd-Chiari syndrome.
- Variceal obliteration in uncontrolled variceal haemorrhage – BRTO, P/CARTO etc.
- Portal vein interventions – in portal vein thrombosis
- Percutaneous transhepatic biliary drainage (PTBD) and stenting.
- Endobiliary biopsy and ablation.
- Radiologically inserted percutaneous gastrostomy.
- Transarterial chemoembolization (TACE) or TARE (radioembolization) for hepatocellular carcinoma (HCC),
- Portal vein embolization prior to liver resection to promote compensatory hypertrophy to achieve enough functional reserve before resection.
- Transjugular liver biopsy (TJLB) in severe coagulopathy/ascites,
- Bariatric embolisation – embolisation of left gastric artery.
- Hemorrhoidal artery embolisation.
- Long term, tunnelled peritoneal drain – eg. PeritX
Thoracic interventions:
- Bronchial artery embolization for massive hemoptysis.
- Thrombolysis and Mechanical thrombectomy in acute pulmonary embolism.
- Pulmonary AVM embolisation
- Thoracic duct embolisation to manage post surgical complications like chylous leak.
- Ablation of lung lesions.
- Long term, tunnelled pleural drain – eg. PleurX
- Lung biopsy for mass lesions in difficult areas.
Central vascular interventions –
- Central venous angioplasty in dialysis patients and for SVC syndrome
- IVC filter placement to prevent PE.
- Iliac stenting.
- Visceral arteries – Celiac, SMA and IMA plasty/stenting
- IVC thrombolysis, plasty, and stenting.
Peripheral vascular interventions:
- DVT thrombolysis, mechanical thrombectomy.
- Varicose vein ablation – RFA, LASER, microwave ablations and/or foam injection sclerotherapy, glue therapy.
- Vascular malformation – injection sclerotherapy
- dialysis salvage interventions like Fistuloplasty, and thrombolysis.
- PICC line and other tunnelled insertion.
Genitourinary interventions:
- Renal artery angioplasty for RAS.
- Renal artery embolization for pseudoaneurysms, AVF (traumatic or iatrogenic – often post biopsy or nephrostomy)
- Renal angiomyolipoma embolisation.
- Percutaneous renal denervation for resistant hypertension.
- Percutaneous nephrostomy PCN, ureteric stenting.
- Microwave and radiofrequency (RFA) ablation for RCC.
- Transjugular renal biopsy.
- Prostate artery embolization for BPH.
- Varicocele embolization
- Uterine artery embolization for postpartum haemorrhage (a real lifesaver! and saves the uterus too).
- Uterine fibroid embolization.
- Fallopian tube recanalization
- Ovarian vein embolization in pelvic congestion syndrome.
Musculoskeletal interventions:
- Ablation of osteoid osteoma.
- MSK embolisations eg.Geniculate artery embolization for osteoarthritic pain in the knee which prevents or delays knee replacement.
- MSK ablations for soft tissue tumours.
USG guided intra-articular and nerve root steroid injection.
Dr. Pulkit Rangarh: Best Interventional Radiologist in Faridabad, Haryana
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