CIIMS

Radiology, Vascular and Interventional Radiology

Radiology department at CIIMS is one of the oldest advanced radiology diagnostic and therapeutic unit of Nagpur city. It has the most experienced faculties and offers advanced services to the patient during both routine and emergency hours. Early detection is critical in the successful treatment of disease. At CIIMS, our diagnostic radiology department offers outpatient, emergency department, fluoroscopy and inpatient radiology services in a patient-friendly environment with state-of-the-art computerized radiography technology.

It contains four separate subunit

  • CT Scan
  • Digital X-ray and fluoroscopy
  • Sonology unit
  • Interventional Radiology
 
 
This department was started in August 1987, with 2 Siemens X-Ray machines. The 500 mA machines with image intensifier is used for conventional Radiography and special procedures like barium studies. IVP, Meyelograms etc. And the other is a mobile X-Ray unit (60 MA) for the bed side conventional plain X-Rays. The second phase of the development of vascular and Interventional Radiology was started first ever in Central India by Dr. Shrikant Kothekar in Oct. 1990. Interventional Radiology has now became a part of treatment of difficult situations. It can be called pin hole surgery/radiology since the procedure involves percutaneous needle puncture followed by guide wire, catheter introduction and manipulation under x-ray control. Following is the list of indications wherein Interventional Radiology steps in to help relieve condition Non-surgically.
  • To relieve obstruction drainage and stenting in obstructive Uropathy and Jaundice.
  • Fallopian tube recanalization in tubal blocks.
  • To dilate narrowing of stenosis – Renal carotid and peripheral angioplasty.
  • To control bleeding by occluding abnormal communication as in arteriovenous malformations & fistulae. Embolization in Hemoptysis / hematuria / Bleeding PR/PV etc.
  • Carotid stenting for preventing progression of ischemic stroke.
  • IVC filter to prevent pulmonary embolism.
  • Uterine artery embolization of fibroid.
Interventional radiology represents a mix of adventure, innovation and improvisation and has certainly contributed significantly to the patient care in Central India and CIIMS both. The well-done emobilization of prostatic, uterine, bronchial, coeliac arterial bleeds that have won accolades nationally and internationally, are a testimony to this spirit. Needless is to mention our contribution to hepatic, renal, and peripheral vascular disease. Since the beginning, interventional radiology has performed a large number of different procedures briefly given below –
  • Diagnostic procedures – Cerebral angio, Aortogram and peripheral renal mesentric bronchial etc.
  • Angioplasties/Stenting – Carotid, Renal and peripheral.
  • Embolizations – Bronchial , Mesentric, Uterine, Pelvic, AVM, AVF, Neovascularization etc.
  • Percutaneous drainage – Percutaneous Nephrostomy, Uterine stenting, Biliary drainage and Biliary stenting.
  • Percutaneous nephrolithomy
The Department’s First  Many of these procedures have been done for the first time in Central India notably, Adrenal Transaxillary Angiograms, Embolization in superior mesenteric, Radial, Scalp and Renal artery and AVM. Bleeding uterine, Bronchial, Prostatic & mesentric vessels. Renal, subclavian, Peripheral, Angioplasties Percutaneous Nephrolithotomy, Ureteric/biliary stenting, IVC filters etc.
PROBLEMPRESENTATIONETIOLOGYPROCEDURE
Ischemic StrokeHemiplegia/HemiparesisAcute Intracerebral thrombosisLOCAL Intra-arterial Thrombolysis within 3 hours.
Venous infarctconvulsions, unconsciousness, neurodeficitSagittal sinus thrombosisLocal intravenous sagittal sinus thrombolysis
Brain HaemorrhageUnconsciousness,Neuro deficitAV malformation, AneurysmCoil Embolisation or Glue injection
Carotid Artery StenosisTransient Ischemic Attack (TIA)AtherosclerosisAngioplasty and stenting
Bronchial artery to Pulmonary artery fistulaeHaemoptysisTuberculosis/CarcinomaBronchial Artery Embolization
Renal Artery StenosisHypertensionAtherosclerosis, Aorto arteritis Fibromuscular DysplasiaAngioplasty and Stenting
GI BleedingHaematemesis, Malena, Bleeding PRUlcer, Tumor, NSAID Aneurysm, A-V-M AngiodysplasiaEmbolization
Bleeding PVMenorrhagia, Pressure SymptomsUterine Fibroid, Pseudoaneurysm, Pelvic A-V-M Post OperativeUterine artery Embolization
Urinary bleedingHaematuriaAV Malformation,Trauma,Tumor, latrogenicf (Post TURP, Renal biopsy)Embolization
Peripheral Vascular DiseaseClaudication Ulcer GangreneAtherosclerosis, Arteritis, Coarctation of AortaAngioplasty and stenting, LOCAL thrombolysis in acute cases.
DVT with/without Pulmonary EmbolismEdema feet, Pain in chest, BreathlessnessHypercoagulable state, Trauma,infection, Post operativeLocal thrombolysis and IVC filter placement
Portal HypertensionHaematemesis MaleanaCirrhosisTIPS (Trans Jugular interahepatic Portosystemic shunt)
Obstructive UropathyOligouria, Anuria Malaise, Anemia, PainCalculus, StricturePrecutaneous Nephrostomy & D-J Stenting
Female InfertilityInability to conceiveCornual blockFallopian tube recanalisation (FTR)
Osteoporosis of vertebral bodyPain in back TendernessPost menopausal, Old age, Immunosuppresion, HaemangiomaVertebroplasty
ThrombocytopeniaBleedingHypersplenismPartial splenic embolizationy
Vertebro basilar insufficiency(VBI)VertigoStenosis at verebral or basilar arteryVertebro basilar stenting.
Absent RadialSyncopeSubclavian steal syndrome (Subclavian artery stenosis)Subclavian artery stenting.
Pulsatile supraclavicular swellingSwelling, ischemic painTraumatic/latrogenicSubclavian stent graft.
Swelling over head, neck, face and extrimitiesDisfigurement Bleeding pain EpistaxisAVF, Nasopharyngioma AVM Hemangioma, Vascular tumorsEmbolization
CyanosisBreathlessness Polycythemia HemoptysisPulmonary AVM, Aneurysm, AVFPulmonary artery Embolization
Pulsatile abdominal/Thoracic massPainThoracic aortic aneurysm Abdominal aortic aneurysm Middle aortic syndromeStent graft/Stent
Abdominal Pain (Normal investigations)Severe pain/post prandial abdominal painMesentric artery stenosis/Embolic acute mesentric occlusionMesentric artery angioplasty/Local intra arterial thrombolysis.
Male infertility/Pelvic congestion syndromePain MenorrhagiaSpermatic/Ovarian varicocitiesCoil Embolization
Benign Hypertrophy of prostateDifficulty in micturation/RetentionBenign prostatic hyperplasiaEmbolization of porstatic vessels.
HypoglycemiaSyncopeInsulinomaPancreatic artery Embolization
MalignancyCachexiaHepato/Secondaries in LiverChemo Embolization
Acute limb ischemiaAcute pain in extrimity Absent pulsationsThrombo EmbolismLocal intra arterial thrombolysis
Lower motor weaknessAcute neuro deficitSpinal AVM/AVF Hemangioma of vertebral bodyEmbolization
Bowel and Ureteric strictureConstipation/Obstructive UropathyInflammatory/NeoplasiaDilatation and stenting
Tracheal stenosisDifficulty in breathing (Stridor)Extrinsic compression Tumor encasement /TracheaomalaciaTracheal stenting
 

Dr. Pankaj Raut

M.D.(MEDICINE),D.M. (CARDIOLOGIST)

Dr. Manish Juneja

M.D.(MEDICINE),D.M. (CARDIOLOGIST)