Interventional radiology is an advanced medical specialty that encompasses minimally invasive diagnostic and therapeutic procedures performed under imaging guidance. Vascular and non-vascular interventions are performed under the guidance of imaging modalities such as fluoroscopy, ultrasonography, computed tomography, and magnetic resonance imaging. Offering an alternative to open surgery, these procedures are distinguished by smaller incisions, less pain, shorter recovery times, and lower complication rates.
Vascular Interventions
The treatment of diseases related to the vascular system using interventional radiology methods constitutes one of the broadest application areas of this discipline.
Angioplasty and Stent Applications
Balloon angioplasty and stent placement procedures are performed for peripheral artery disease, carotid artery stenosis, and renal artery stenosis. In vessels narrowed or occluded due to atherosclerotic plaque, the vessel lumen is widened by inflating a balloon advanced via a catheter. When necessary, a metallic or drug-eluting stent is placed to ensure the vessel remains open.
In lower extremity peripheral artery disease, interventional treatment significantly reduces the risk of amputation in patients with critical limb ischemia. In patients with intermittent claudication, a significant improvement in quality of life is achieved.
Embolization Treatments
Embolization is an interventional treatment method that provides controlled occlusion of a target vessel. Embolization procedures applied for different clinical indications include:
- Uterine artery embolization: A uterus-sparing, minimally invasive method that provides treatment for fibroids without the need for surgical intervention, preferred especially in patients who wish to preserve their fertility.
- Trauma and hemorrhage control: Providing hemorrhage control via emergency embolization in cases of pelvic fractures, postpartum hemorrhage, gastrointestinal bleeding, and acute hemorrhages originating from tumors.
- Varicocele embolization: Performing percutaneous embolization as an alternative to surgical ligation in the treatment of varicocele, which is frequently encountered in male infertility.
- Hepatic chemoembolization (TACE): Occlusion of the artery feeding the tumor in liver tumors, combined with chemotherapeutic agents and embolic material.
- Bronchial artery embolization: Selective embolization of the bleeding bronchial artery in cases of massive hemoptysis (severe pulmonary hemorrhage).
- Arteriovenous malformation treatment: Treatment of vascular anomalies in the brain, lungs, or other organs via embolization.
Biopsy and Drainage Procedures
Biopsy procedures performed under imaging guidance allow for tissue diagnosis using a less invasive method compared to surgical biopsy.
- Liver biopsy: Percutaneous biopsy under ultrasonography guidance for fibrosis staging and diagnosis of diffuse parenchymal disease in chronic liver diseases.
- Lung biopsy: Histopathological diagnosis of peripheral lung nodules via CT-guided transthoracic needle biopsy.
- Kidney biopsy: Renal biopsy under ultrasonography guidance for the diagnosis of glomerular diseases and evaluation of transplant kidney rejection.
- Bone and soft tissue biopsy: Diagnosis of musculoskeletal masses via percutaneous biopsy under CT or ultrasonography guidance.
- Abscess drainage: Treatment of intra-abdominal, pelvic, and intrathoracic abscess collections via percutaneous catheter drainage.
Fluid Collection Drainage
Safe drainage of pathological fluid accumulations such as pleural effusion, ascites, and pericardial effusion is performed under ultrasonography guidance. Permanent catheter placement for recurrent effusions can also be performed in the interventional radiology unit.
Oncological Interventional Radiology
In cancer treatment, interventional radiology methods have an increasingly important role as a complement to surgery and systemic therapy.
- Radiofrequency ablation (RFA): Thermal destruction of tumor tissue using high-frequency electric current in liver, kidney, and lung tumors.
- Microwave ablation: A thermal ablation method that can create larger ablation zones and offers shorter procedure times compared to radiofrequency ablation.
- Cryoablation: Achieving tumor cell death through freezing in kidney tumors and bone metastases.
- Transarterial chemoembolization (TACE): Locoregional treatment for hepatocellular carcinoma and liver metastases.
- Radioembolization (TARE/SIRT): Selective delivery of Yttrium-90 loaded microspheres to the tumor via the hepatic artery.
- Port catheter placement: Implantation of a subcutaneous port system under fluoroscopy guidance for chemotherapy administration.
Neurovascular Interventions
Interventional radiology methods play a critical role in the treatment of cerebrovascular diseases. Procedures such as cerebral aneurysm coiling, mechanical thrombectomy in acute ischemic stroke, and arteriovenous malformation embolization are performed by specialists with experience in neuroradiology.
Endovascular thrombectomy in acute ischemic stroke has become the gold standard treatment for large vessel occlusions. Mechanical thrombectomy, when applied within the determined time window from symptom onset, significantly reduces permanent neurological damage.
Venous Interventions
Interventional radiology methods are increasingly preferred in the treatment of deep vein thrombosis and pulmonary embolism:
- Catheter-directed thrombolysis: Infusion of thrombolytic agents directly into the thrombus in acute deep vein thrombosis.
- Mechanical thrombectomy: Catheter-based clot removal procedure in pulmonary embolism and iliofemoral vein thrombosis.
- Inferior vena cava filter: Placement of a temporary or permanent filter in cases where anticoagulation is contraindicated or in cases of recurrent pulmonary embolism despite treatment.
- Dialysis access interventions: Balloon angioplasty and thrombectomy for arteriovenous fistula and graft stenoses.
Pre-Interventional Assessment and Patient Preparation
A detailed patient assessment is performed before every interventional radiology procedure. Existing imaging findings are reviewed, laboratory parameters (coagulation profile, kidney function tests) are checked, and the medications used by the patient are reviewed. A medication management protocol is applied for patients using anticoagulant and antiplatelet therapy.
The patient is informed about all procedures via an informed consent form; the risks, benefits, and alternatives of the procedure are explained in detail.
Within the Koru Hospital Interventional Radiology Center, we offer our patients safe and effective alternatives to surgical intervention by performing diagnostic and therapeutic procedures under minimally invasive imaging guidance with our expert staff. Our experienced interventional radiology team creates treatment plans specific to each patient using advanced technology angiography systems and multidisciplinary collaboration.