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Interventional Imaging

Standard Interventional Procedures

Vascular

Angiogram: Visualisation of vessels under x-ray imaging

Transfemoral Angiography (TFA): Angiogram of the lower limb vessels from hip to foot.

Percutaneous Transluminal Angioplasty (PTA): Ballooning (also known as plasty) of a stenosis in the artery. Various size balloons are used to stretch the vessel to keep the narrowing open.

Stent Insertion: If the vessel is unlikely to stay sufficiently open a metal stent is inserted to hold the artery open.

Thrombolysis + Rescreen: A catheter with small holes along it, is inserted into a large blockage and a clot busting drug known as Actilyse (TPA) is given through it over a period of hours. The patient is then rescreened to see if the clot has been sufficiently dissolved.

Endovascular Aortic Repair (EVAR): Joined venture between the vascular theatre team and Radiology. The vascular surgeon does the ‘Cut Down’ (open surgery) so that access can be gained to the artery. The radiologist then takes over and inserts the specialised aortic stents (usually comes in 3 parts) with the use of wires and catheters. Contrast is injected into the abdominal aorta; imaging is acquired to plan the insertion of the stents. After the stents have been correctly inserted another contrast injection is performed and the surgeons will close up.

Mesenteric Embolisation: Embolisation (blocking off a bleed) of mesenteric artery in the abdomen due to a bleed. This is done with either gel foam or coils.  

Uterine Fibroid Embolisation (UFE): Embolisation of uterine fibroids by the use of materials to block flow. Resulting in the blood supply being stopped to the fibroid from the uterine artery, the fibroid should shrink and starts to ‘die’ hopefully relieving the patient’s symptoms.

Inferior Venacava Filter (IVC): A filter (which looks like an umbrella) is inserted into the IVC via the groin. Its purpose is to catch any blood clots that may occur in patients with venous thromboembolism (VTE) who have a contraindication to anticoagulation therefore preventing pulmonary emboli. They are usually not permanent and are removed via the right jugular.

Biliary

Percutaneous Transhepatic Cholangiogram (PTC): Drains are inserted percutaneously with wires and catheters into the bile ducts to relieve the symptoms of jaundice usually caused by an obstruction in one of the ducts.

Renal & Urology

Varicocele Embolisation: Varicocele occurs when the network of veins that leaves the testis (pampiniform plexus) become elongated and enlarged. If there is something wrong with them the blood builds up.The procedure therefore involves embolisation of arteries in the testes.

Renal Embolisation: Blocking the blood supply to the kidney or part of it via the renal arteries

Fistulogram: A surgeon creates an arteriovenous (AV) fistula by connecting an artery directly to a vein, frequently in the forearm. Connecting the artery to the vein causes more blood to flow into the vein. As a result, the vein grows larger and stronger, making repeated needle insertions for haemodialysis treatments easier. They take a while after surgery to develop and can often develop narrowing or stenosis in them. A fistulogram is images of the fistula pathway, to see if there are any such narrowing’s.

Fistuloplasty: Ballooning of a narrowed fistula to improve flow for dialysis.

Nephrostogram: Contrast is put through the tube of a nephrostomy to see the position of the drain.

Nephrostomy: A drain inserted percutaneously into the kidneyto drain urine straight from the kidney relieving any obstruction that may have occurred due to an infection or stone for instance.

Ureteric Stent: A stent (small tube) placed to prevent or treat obstruction of the kidney to enable the passage of urine.  

Line Insertions:

Hickman Line: The administration of chemotherapy or other medications, as well as for the withdrawal of blood for analysis. It is inserted into the chest usually via the jugular. They come as either single or double lumen lines.

Tunnelled Dialysis Line: Is a central venous catheter most often used for dialysis. Dialysis lines are very similar to Hickman lines only the lumen is bigger to allow for efficient flow for dialysis. There are two lumens for inflow and one out.

Linogram: Contrast is put through the line to confirm position and any leaks

Peripherally Inserted Central Catheter Line (PICC): A catheter that is inserted through one of the veins in the forearm with the tip positioned just above the heart

Portacath: One end of the tube sits in a vein (usually just above the heart) and the other end is attached to the injection port that sits underneath the skin on the chest. Porta-caths are usually recommended for patients who need certain types of medicines or treatments that irritate or damage the smaller veins; or whom need injections over a long period of time.

 

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Last updated - 28 October 2014
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