Radiology, Vascular and Interventional Radiology
Department of 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
Interventions Radiology Unit :
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.
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.
WHERE INTERVENTIONAL RADIOLOGY SAVES LIMB, BRAIN &LIFE
| PROMBLES | PRESENTATION | ETIOLOGY | PROCEDURE |
|---|---|---|---|
| Ischemic Stroke | Hemiplegia/Hemiparesis | Acute Intracerebral thrombosis | LOCAL Intra-arterial Thrombolysis within 3 hours. |
| Venous infarct | convulsions, unconsciousness, neurodeficit | Sagittal sinus thrombosis | Local intravenous sagittal sinus thrombolysis |
| Brain Haemorrhage | Unconsciousness,Neuro deficit | AV malformation, Aneurysm | Coil Embolisation or Glue injection |
| Carotid Artery Stenosis | Transient Ischemic Attack (TIA) | Atherosclerosis | Angioplasty and stenting |
| Bronchial artery to Pulmonary artery fistulae | Haemoptysis | Tuberculosis/Carcinoma | Bronchial Artery Embolization |
| Renal Artery Stenosis | Hypertension . | Atherosclerosis, Aorto arteritis Fibromuscular Dysplasia | Angioplasty and Stenting |
| GI Bleeding | Haematemesis, Malena, Bleeding PR | Ulcer, Tumor, NSAID Aneurysm, A-V-M Angiodysplasia | Embolization |
| Bleeding PV | Menorrhagia, Pressure Symptoms | Uterine Fibroid, Pseudoaneurysm, Pelvic A-V-M Post Operative | Uterine artery Embolization |
| Urinary bleeding | Haematuria | AV Malformation,Trauma,Tumor, latrogenicf (Post TURP, Renal biopsy) | Embolization |
| Peripheral Vascular Disease | Claudication Ulcer Gangrene | Atherosclerosis, Arteritis, Coarctation of Aorta |
Angioplasty and stenting, LOCAL thrombolysis in acute cases. |
| DVT with/without Pulmonary Embolism | Edema feet, Pain in chest, Breathlessness |
Hypercoagulable state, Trauma,infection, Post operative | Local thrombolysis and IVC filter placement |
| Portal Hypertension | Haematemesis Maleana | Cirrhosis | TIPS (Trans Jugular interahepatic Portosystemic shunt) |
| Obstructive Jaundice | Jaundice/Itching | Biliary stricture/Calculus | PTBD/Stenting |
| Obstructive Uropathy | Oligouria, Anuria Malaise, Anemia, Pain | Calculus, Stricture | Precutaneous Nephrostomy & D-J Stenting |
| Female Infertility | Inability to conceive | Cornual block | Fallopian tube recanalisation (FTR) |
| Osteoporosis of vertebral body | Pain in back Tenderness | Post menopausal, Old age, Immunosuppresion, Haemangioma | Vertebroplasty |
| Thrombocytopenia | Bleeding | Hypersplenism | Partial splenic embolization |
| Vertebro basilar insufficiency(VBI) | Vertigo | Stenosis at verebral or basilar artery | Vertebro basilar stenting. |
| Absent Radial | Syncope | Subclavian steal syndrome (Subclavian artery stenosis) | Subclavian artery stenting. |
| Pulsatile supraclavicular swelling | Swelling, ischemic pain | Traumatic/latrogenic | Subclavian stent graft. |
| Swelling over head, neck, face and extrimities | Disfigurement Bleeding pain Epistaxis | AVF, Nasopharyngioma AVM Hemangioma, Vascular tumors | Embolization |
| Cyanosis | Breathlessness Polycythemia Hemoptysis | Pulmonary AVM, Aneurysm, AVF | Pulmonary artery Embolization |
| Pulsatile abdominal/Thoracic mass | Pain | Thoracic aortic aneurysm Abdominal aortic aneurysm Middle aortic syndrome | Stent graft/Stent |
| Abdominal Pain (Normal investigations) | Severe pain/post prandial abdominal pain | Mesentric artery stenosis/Embolic acute mesentric occlusion | Mesentric artery angioplasty/Local intra arterial thrombolysis. |
| Male infertility/Pelvic congestion syndrome | Pain Menorrhagia | Spermatic/Ovarian varicocities | Coil Embolization |
| Benign Hypertrophy of prostate | Difficulty in micturation/Retention | Benign prostatic hyperplasia | Embolization of porstatic vessels. |
| Hypoglycemia | Syncope | Insulinoma | Pancreatic artery Embolization |
| Malignancy | Cachexia | Hepato/Secondaries in Liver | Chemo Embolization |
| Acute limb ischemia | Acute pain in extrimity Absent pulsations | Thrombo Embolism | Local intra arterial thrombolysis |
| Lower motor weakness | Acute neuro deficit | Spinal AVM/AVF Hemangioma of vertebral body | Embolization |
| Bowel and Ureteric stricture | Constipation/Obstructive Uropathy | Inflammatory/Neoplasia | Dilatation and stenting |
| Tracheal stenosis | Difficulty in breathing (Stridor) | Extrinsic compression Tumor encasement /Tracheaomalacia | Tracheal stenting |