INTERVENTIONAL RADIOLOGY

Transcription

1 INTERVENTIONAL RADIOLOGY Nagy Endre UNIVERSITY of SZEGED DEPARTMENT of RADIOLOGY

2 Percutaneous catheter-technique was developd by Sven-Ivar Seldinger in 1953

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4 Interventional procedures intravascular extravascular

5 vascular disorders stenosis occlusion acute chronic enlargement arterio-venous malformation injuries pathologic (tumor) circulation

6 The most common causes of stenosis atherosclerosis fibromuscular dysplasia diabetic angiopathy arteritis endothel proliferation tumor dissection (hematoma or other external compression)

7 Intravascular interventions dilatation of a narrowed vessel balloon dilatation atherectomy stent implantation

8 Intravascular interventions dilatation of a narrowed vessel balloon dilatation atherectomy stent implantation

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10 PAROSTIAL STENOSIS (fibromuscular dysplasia)

11 Intravascular interventions dilatation of a narrowed vessel balloon dilatation atherectomy stent implantation

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13 Intravascular interventions dilatation of a narrowed vessel balloon dilatation atherectomy stent implantation

14 Types of stents balloon-expandable stent (stainless steel, tantal) self-expandable stent ellastic stainless steel (Wallstent) thermo-shape-memory stents (NITINOL) covered stents, stentgrafts absorbable metal stent (magnesium)

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16 PAROSTIAL STENOSIS

17 ILIAC ARTERY ATHERECTOMY + STENT IMPLANTATION

18 Intravascular interventions Methods of recanalisation guide wire + catheter rotating tip catheters laser catheter

19 Intravascular interventions recanalising methods guide wire + catheter rotating tip catheters laser catheter

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21 Intravascular interventions recanalising methods guide wire + catheter rotating tip catheters laser catheter

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23 COMMON ILIAC ARTERY REOCCLUSION

24 Intravascular interventions Methods of recanalisation thrombolysis systemic selective

25 Intravascular interventions recanalising methods thrombolysis systemic selective catheter infusion pulse spray technic

26 Acute thromboembolisation

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28 Renal stent thrombus

29 Intravascular interventions Methods of recanalisation thrombus removal Fogarty-catheter aspiration hydrolysis catheters

30 Intravascular interventions Methods of recanalisation thrombus removal Fogarty-catheter aspiration hydrolysis catheters

31 Thrombus aspiration

32 Intravascular interventions Methods of recanalisation thrombus removal Fogarty-catheter aspiration hydrolysis catheters

33 Hydrolyser Hydrolyser Oasis

34 Hydrolyser Recanalisation

35 Intravascular interventions cava filters temporary removable definitive

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37 Cava filter implantation

38 Intravascular interventions artefitial occlusion of vessels arterial occlusion (embolisation) venous occlusion (sclerotisation)

39 Occlusion devices for large vessels occlusion coils detachable balloons nitinol plug venous occlusion sclerotisation (aethoxy sklerol) ablation (cryo-,laser-,thermo-) for middle and small vessels occlusion micro spirals gelfoam PVA Embosphere (acryl co-polymer) capillary level occlusison 96% ethanol ethoxy sclerol ethibloc, etc.

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41 KIDNEY TUMOR EMBOLISATION

42 UTERUS FIBROID EMBOLISATION

43 UTERUS FIBROID EBOLISATION

44 Intravascular interventions chemotherapy systemic regional intraarterial intraparenchymal regional + hemofiltration chemoembolisation

45 PORT CATCH (chemotherapy)

46 Extravascular interventions guiding possibilities fluoroscopy US CT MR

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48 Extravascular interventions (regions) liver interventions urological interventions gastrointestinal interventions lung interventions

49 Extravascular interventions tissue sampling cytological hystological

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51 Extravascular interventions fluid removal aspiration drenage

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54 Abscess drainage

55 Extravascular interventions percutan tumor ablations percutan ethanol tumor ablation crioablation radiofrequency tumor ablations nano knife technology

56 Unipolar systems

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58 Nano knife technolgy

59 organs, regions heart: heart: stimulationstimulation-and impulse impulse conduction disorders liver: liver: primery primery tumors tumors, metastasis) lung: lung: primery primery tumors tumors, metastasis kidneys: kidneys: primery primery tumors tumors, metastasis bones: bones: metastasis, osteoid osteoma breast: breast: primery primery tumors tumors, (metastasis) prostate prostate recurrent tumors in the pelvis myoma tonsilla: chronic tonsillitis

60 Possible complications in the interventional radiology bleeding vascular occlusion ptx biliary leakage (to abdominal cavity, to external) urinary leakage (to abdominal cavity, to external) gastrointestinal perforation peritoneal infection, etc.

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