Interventional radiology: the alternative to surgery

Interventional radiology

Over the last twenty years, Interventional Radiology has gained momentum offering an invaluable alternative to surgical treatment. This due to the fact that in the majority of cases, interventional treatments mean shorter hospital stays, do not require general anaesthesia and involve less risk, pain and shorter recovery times compared to conventional surgery.1

 

What is Interventional Radiology?

Interventional Radiology is a radiology subspecialty in which imaging techniques are used for minimally invasive procedures. Some of these procedures are for purely diagnostic purposes (e.g. angiogram), while others are performed as part of specific treatments (e.g. angioplasty).

 

What is its objective?

The objective of Interventional Radiology is the diagnosis or treatment of pathologies with minimally invasive techniques2. It uses vision from imaging via X-rays to direct radiological procedures which are usually performed with needles, guidewires and catheters. The images provide a guide that enables the radiologist to advance these instruments through the body to the selected areas. By minimising the physical trauma to the patient, infection rates and recovery times are reduced and post-operative hospital stays are shortened.

 

Imaging techniques

Predominantly, fluoroscopy is used, which is a way of working in real time. Currently the “fluoro”, as it is usually called, is almost exclusively used, with radiological tubes and intensifiers mounted on a “C” arch. It uses ionising radiation3.

Another way of working in real time is ultrasound, enabling the directing of needles for vascular accesses, reaching organs to take biopsies, and drain collections safely. Interventional ultrasound is usually linked to fluoroscopy.

Computerised tomography4 is a very useful tool to access different types of lesions. It is usually a static way of working, though there are devices that enable working in real time using fluorotomography. It is not very popular due to the high irradiation of the operator. It uses ionising radiation.

Magnetic resonance enables some types of interventionism with special materials and open devices. It is not so popular.5

What is treated with Interventional Radiology techniques?

The anatomical regions and the symptoms that can be treated using Interventional Radiology techniques are:

  • Central nervous system (brain, spinal column).
  • Chest (airways and lungs).
  • Abdomen (liver, stomach, intestine, kidneys).
  • Circulatory system (heart, arteries and veins).
  • Musculoskeletal system (bones, joints, spinal column).
  • Urogenital system (male and female).
  • Others (obtaining of samples from all organs and tissues).