TeleConsultation

Interventional Radiology

Interventional radiology is a medical subspecialty in which radiologists perform Minimally-Invasive
procedures utilizing the guidance of radiological techniques (including X-ray Fluoroscopy, CT scan and
Ultrasound).

The Interventional Radiology division of the Department of Radiology at Royal Care Hospital is equipped
with State-of-the-art imaging technology.

This includes,

“The Digital Subtraction Angiography (DSA) lab IGS 520 from GE –

The heart of any Interventional
Radiology unit is the DSA Lab. Apart from the routine Fluoroscopy, Digital subtraction imaging and 2D
roadmapping facilities, this advanced lab also is loaded with cutting-edge software features including
3D rotational angiography, 3D road-mapping and Needle tracking softwares. These softwares are
essential in performing complex Neurovascular Interventions and challenging percutaneous needle-
guided procedures.

 Ultrasonography – Philips Epiq 5G – Equipped with Needle-guidance and needle enhancement
softwares which aid in the performance of percutaneous procedures.
 Computed Tomography CT scanner – Siemens Somatom Scope
We provide Interventional Radiological services catering to a wide variety of Medical Subspecialties. This
includes,

Neurovascular interventions
 Acute Stroke interventions (Thrombectomy)
 Intracranial aneurysm treatment – Coiling, Flow diverters
 Carotid-cavernous fistula treatment – Coiling
 Embolization of Intracranial Arteriovenous malformations (Pial and Dural AVMs) – With Onyx and/or
glue
 Carotid artery stenting

Peripheral vascular interventions
 Peripheral vascular disease – Angioplasty and stenting
 Bronchial artery embolization for haemoptysis
 Uterine artery embolization for fibroids
 Tumor embolization
 Transarterial chemoembolization (TACE) for Liver tumors (Hepatocellular carcinoma)
 Acute limb ischemia (Thrombectomy and/or Intra-arterial thrombolysis)

 Acute gastrointestinal haemorrhage
 Venous interventions for Budd-Chiari syndrome
 IVC filter placement
 Varicose vein treatment – Laser / RFA

Non-vascular interventions
 Percutaneous transhepatic biliary drainage (PTBD) and Antegrade biliary stenting
 Percutaneous nephrostomy (PCN) and Antegrade DJ stenting
 Radiofrequency ablation for Liver tumors
 Microwave ablation for Liver tumors
 Image-guided (CT/USG) Percutaneous drainage procedures
 Image-guided (CT/USG/Fluoroscopy) biopsies
We provide round-the-clock support in the management of Acute vascular emergencies – Like Acute
Stroke, Acute limb ischemia, Traumatic vascular injuries, Acute gastrointestinal haemorrhage.
We are presenting a few of the Neurovascular procedures that we have performed in the last year.

Thrombectomy for Acute Stroke
Interventional radiology has now become a
mainstay in management of Acute ischemic
stroke. In addition to IV thrombolysis in cases
presenting in window period (<4.5 hours),
endovascular treatment (Thrombectomy) is
performed for cases with large vessel occlusion
(like ICA, M1-segment of MCA).
Case –
A 60 year old male patient presented with acute-
onset of weakness of left upper and lower limb
(Grade 2/5 power) associated with deviation of
angle of mouth. Patient presented to Emergency
room 2 hours after symptom onset. Non-contrast
CT did not show any abnormality. A CT
angiogram revealed occlusion of right Middle
cerebral artery. Patient was shifted to the DSA
lab and a thrombectomy done. The procedure
was completed within 1.5 hours of presenting to
the hospital. Patient’s power gradually improved
over the next few days and at the time of
discharge, the limb power was 4+/5.

Aneurysm Coiling –
Case –
A 57 year old male presented with history of
acute-onset headache (Thunderclap headache)
of 7 hours duration. CT revealed Subarachnoid
haemorrhage involving the CSF cisterns of the
posterior fossa. DSA done revealed a wide-
necked aneurysm involving the Posterior inferior
cerebellar artery (PICA) origin.
The patient was taken for aneurysm coiling. As
the aneurysm was wide-necked, a balloon was
navigated across the neck of the aneurysm via
the opposite vertebral artery and basilar artery
and coiling of the aneurysm was successfully
accomplished. The patient was managed for his
SAH and was discharged 2 weeks later with no
neurological deficit.

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