Department of Radiology, Vascular and Interventional Radiology

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Facilities and Equipments :

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.

Catheterization Laboratory   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
Catheterization Laboratory   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
PROBLEM 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