Advertisement

The Role of Interventional Radiology

  • Stefan Wirth
  • Marcus Treitl
Part of the Medical Radiology book series (MEDRAD)

Abstract

Over the past decades technical developments have highly influenced the field of interventional radiology. High-speed, sub-millimetric resolution has triggered increasing indications for cross-sectional imaging with highest diagnostic and thus therapeutic value. From the interventional point of view this results in two major effects. First, in angiography a shift in daily routine working from diagnostic to therapeutic procedures is evident. Second, CT is taking over many procedures, which were formerly performed using ultrasound or fluoroscopic guidance. However, due to its minimal-invasive nature, the cardinal benefit of interventional radiology is to speed up therapy with lower risks for the patients and shortened hospitalization.

Keywords

Digital Subtraction Angiography Endovascular Treatment Pelvic Fracture Access Route Embolic Agent 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Arellano RS, Gervais DA, Mueller PR (2011) CT-guided drainage of abdominal abscesses: hydrodissection to create access routes for percutaneous drainage. AJR Am J Roentgenol 196(1):189–191PubMedCrossRefGoogle Scholar
  2. Beland MD, Gervais DA, Levis DA, Hahn PF, Arellano RS, Mueller PR (2008) Complex abdominal and pelvic abscesses: efficacy of adjunctive tissue-type plasminogen activator for drainage. Radiology 247(2):567–573PubMedCrossRefGoogle Scholar
  3. Bilbao JI, Torres E, Martinez-Cuesta A (2002) Non-traumatic abdominal emergencies: imaging and intervention in gastrointestinal hemorrhage and ischemia. Eur Radiol 12(9):2161–2171PubMedGoogle Scholar
  4. Covey AM, Brown KT (2008) Percutaneous transhepatic biliary drainage. Tech Vasc Interv Radiol 11(1):14–20PubMedCrossRefGoogle Scholar
  5. Cronin CG, Gervais DA, Hahn PF, Arellano R, Guimaraes AR, Mueller PR (2011) Treatment of deep intramuscular and musculoskeletal abscess: experience with 99 CT-guided percutaneous catheter drainage procedures. AJR Am J Roentgenol 196(5):1182–1188PubMedCrossRefGoogle Scholar
  6. Dinkel HP, Danuser H, Triller J (2002) Blunt renal trauma: minimally invasive management with microcatheter embolization experience in nine patients. Radiology 223(3):723–730PubMedCrossRefGoogle Scholar
  7. Fang JF, Wong YC, Lin BC, Hsu YP, Chen MF (2006) The CT risk factors for the need of operative treatment in initially hemodynamically stable patients after blunt hepatic trauma. J Trauma 61(3):547–553 discussion 53-4PubMedCrossRefGoogle Scholar
  8. Frevert S, Dahl B, Lonn L (2008) Update on the roles of angiography and embolisation in pelvic fracture. Injury 39(11):1290–1294PubMedCrossRefGoogle Scholar
  9. Gee MS, Kim JY, Gervais DA, Hahn PF, Mueller PR (2010) Management of abdominal and pelvic abscesses that persist despite satisfactory percutaneous drainage catheter placement. AJR Am J Roentgenol 194(3):815–820PubMedCrossRefGoogle Scholar
  10. Gervais DA, Brown SD, Connolly SA, Brec SL, Harisinghani MG, Mueller PR (2004) Percutaneous imaging-guided abdominal and pelvic abscess drainage in children. Radiographics 24(3):737–754PubMedCrossRefGoogle Scholar
  11. Ginat D, Saad WE (2008) Cholecystostomy and transcholecystic biliary access. Tech Vasc Interv Radiol 11(1):2–13PubMedCrossRefGoogle Scholar
  12. Haaga JR, Nakamoto D, Stellato T, Novak RD, Gavant ML, Silverman SG, Bellmore M (2000) Intracavitary urokinase for enhancement of percutaneous abscess drainage: phase II trial. AJR Am J Roentgenol 174(6):1681–1685PubMedGoogle Scholar
  13. Haan JM, Biffl W, Knudson MM, Davis KA, Oka T, Majercik S, Dicker R, Marder S, Scalea TM (2004) Splenic embolization revisited: a multicenter review. J Trauma 56(3):542–547PubMedCrossRefGoogle Scholar
  14. Haan JM, Bochicchio GV, Kramer N, Scalea TM (2005) Nonoperative management of blunt splenic injury: a 5-year experience. J Trauma 58(3):492–498PubMedCrossRefGoogle Scholar
  15. Harisinghani MG, Gervais DA, Maher MM, Cho CH, Hahn PF, Varghese J, Mueller PR (2003) Transgluteal approach for percutaneous drainage of deep pelvic abscesses: 154 cases. Radiology 228(3):701–705PubMedCrossRefGoogle Scholar
  16. Hoffmann RT, Jakobs TF, Trumm C, Weber C, Glaser C, Reiser MF (2007) Vertebroplasty in the treatment of osteoporotic vertebral body fracture. Eur Radiol 17(10):2656–2662PubMedCrossRefGoogle Scholar
  17. Holden A (2008) Abdomen—interventions for solid organ injury. Injury 39(11):1275–1289PubMedCrossRefGoogle Scholar
  18. Iguchi T, Ogawa K, Doi T, Miyasho K, Munetomo K, Hiraki T, Ozaki T, Kanazawa S (2010) Computed tomography fluoroscopy-guided placement of iliosacral screws in patients with unstable posterior pelvic fractures. Skelet Radiol 39(7):701–705CrossRefGoogle Scholar
  19. Kasirajan K, O’Hara PJ, Gray BH, Hertzer NR, Clair DG, Greenberg RK, Krajewski LP, Beven EG, Ouriel K (2001) Chronic mesenteric ischemia: open surgery versus percutaneous angioplasty and stenting. J Vasc Surg 33(1):63–71PubMedCrossRefGoogle Scholar
  20. Kirat HT, Remzi FH, Shen B, Kiran RP (2011) Pelvic abscess associated with anastomotic leak in patients with ileal pouch-anal anastomosis (IPAA): transanastomotic or CT-guided drainage? Int J Colorectal Dis [serial online]. Available at: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=21773700. Accessed 20 July 2011
  21. Kokotsakis JN, Lambidis CD, Lioulias AG, Skouteli ET, Bastounis EA, Livesay JJ (2000) Celiac artery compression syndrome. Cardiovasc Surg 8(3):219–222PubMedCrossRefGoogle Scholar
  22. Kozar RA, Moore JB, Niles SE, Holcomb JB, Moore EE, Cothren CC, Hartwell E, Moore FA (2005) Complications of nonoperative management of high-grade blunt hepatic injuries. J Trauma 59(5):1066–1071PubMedCrossRefGoogle Scholar
  23. Kruger K, Heindel W, Dolken W, Landwehr P, Lackner K (1996) Angiographic detection of gastrointestinal bleeding. An experimental comparison of conventional screen-film angiography and digital subtraction angiography. Invest Radiol 31(7):451–457PubMedCrossRefGoogle Scholar
  24. Kuhn JP, Busemann A, Lerch MM, Heidecke CD, Hosten N, Puls R (2010) Percutaneous biliary drainage in patients with nondilated intrahepatic bile ducts compared with patients with dilated intrahepatic bile ducts. AJR Am J Roentgenol 195(4):851–857PubMedCrossRefGoogle Scholar
  25. Landwehr P, Arnold S, Voshage G, Reimer P (2008) Embolotherapy: principles and indications. Radiologe 48(1):73–95 quiz 6–7PubMedCrossRefGoogle Scholar
  26. Levenson RB, Pearson KM, Saokar A, Lee SI, Mueller PR, Hahn PF (2009) Image-guided drainage of tuboovarian abscesses of gastrointestinal or genitourinary origin: a retrospective analysis. J Vasc Interv Radiol 22(5):678–686CrossRefGoogle Scholar
  27. Linsenmaier U, Kanz KG, Rieger J, Krotz M, Mutschler W, Pfeifer KJ, Reiser M (2003) CT-guided aortic balloon occlusion in traumatic abdominal and pelvic bleeding. Rofo 175(9):1259–1263PubMedCrossRefGoogle Scholar
  28. Liu CH, Gervais DA, Hahn PF, Arellano RS, Uppot RN, Mueller PR (2009) Percutaneous hepatic abscess drainage: do multiple abscesses or multiloculated abscesses preclude drainage or affect outcome? J Vasc Interv Radiol 20(8):1059–1065PubMedCrossRefGoogle Scholar
  29. Lucey BC, Varghese JC, Hochberg A, Blake MA, Soto JA (2007) CT-guided intervention with low radiation dose: feasibility and experience. AJR Am J Roentgenol 188(5):1187–1194PubMedCrossRefGoogle Scholar
  30. Maher MM, Gervais DA, Kalra MK, Lucey B, Sahani DV, Arellano R, Hahn PF, Mueller PR (2004) The inaccessible or undrainable abscess: how to drain it. Radiographics 24(3):717–735PubMedCrossRefGoogle Scholar
  31. Malhotra AK, Fabian TC, Croce MA, Gavin TJ, Kudsk KA, Minard G, Pritchard FE (2000) Blunt hepatic injury: a paradigm shift from operative to nonoperative management in the 1990s. Ann Surg 231(6):804–813PubMedCrossRefGoogle Scholar
  32. Men S, Akhan O, Koroglu M (2002) Percutaneous drainage of abdominal abcess. Eur J Radiol 43(3):204–218PubMedCrossRefGoogle Scholar
  33. Menu Y, Vuillerme MP (2002) Non-traumatic abdominal emergencies: imaging and intervention in acute biliary conditions. Eur Radiol 12(10):2397–2406PubMedGoogle Scholar
  34. Meredith JW, Young JS, Bowling J, Roboussin D (1994) Nonoperative management of blunt hepatic trauma: the exception or the rule? J Trauma 36(4):529–534 discussion 34-5PubMedCrossRefGoogle Scholar
  35. Miller DL, Balter S, Schueler BA, Wagner LK, Strauss KJ, Vano E (2010) Clinical radiation management for fluoroscopically guided interventional procedures. Radiology 257(2):321–332PubMedCrossRefGoogle Scholar
  36. Mohr AM, Lavery RF, Barone A, Bahramipour P, Magnotti LJ, Osband AJ, Sifri Z, Livingston DH (2003) Angiographic embolization for liver injuries: low mortality, high morbidity. J Trauma 55(6):1077–1081 discussion 81-2PubMedCrossRefGoogle Scholar
  37. Nix JA, Costanza M, Daley BJ, Powell MA, Enderson BL (2001) Outcome of the current management of splenic injuries. J Trauma 50(5):835–842PubMedCrossRefGoogle Scholar
  38. Pachter HL, Guth AA, Hofstetter SR, Spencer FC (1998) Changing patterns in the management of splenic trauma: the impact of nonoperative management. Ann Surg 227(5):708–717 discussion 17-9PubMedCrossRefGoogle Scholar
  39. Pedicini V, Poretti D, Mauri G, Trimboli M, Brambilla G, Sconfienza LM, Cornalba G, Sardanelli F (2010) Management of post-surgical biliary leakage with percutaneous transhepatic biliary drainage (PTBD) and occlusion balloon (OB) in patients without dilatation of the biliary tree: preliminary results. Eur Radiol 20(5):1061–1068PubMedCrossRefGoogle Scholar
  40. Popovic P, Kuhelj D, Bunc M (2011) Superior mesenteric artery embolism treated with percutaneous mechanical thrombectomy. Cardiovasc Interv Radiol 34(Suppl 2):S67–S69CrossRefGoogle Scholar
  41. Ramirez JI, Velmahos GC, Best CR, Chan LS, Demetriades D (2004) Male sexual function after bilateral internal iliac artery embolization for pelvic fracture. J Trauma 56(4):734–739 discussion 9-41PubMedCrossRefGoogle Scholar
  42. Rieger J, Linsenmaier U, Euler E, Rock C, Pfeifer KJ (1999) Temporary balloon occlusion as therapy of uncontrollable arterial hemorrhage in multiple trauma patients. Rofo 170(1):80–83PubMedGoogle Scholar
  43. Rundback JH, Rozenblat GN, Poplausky M, Crea G, Maddineni S, Olson C, Agrawal U (2000) Re: jejunal artery angioplasty and coronary stent placement for acute mesenteric ischemia. Cardiovasc Interv Radiol 23(5):410–412CrossRefGoogle Scholar
  44. Saad WE (2008) Transhepatic techniques for accessing the biliary tract. Tech Vasc Interv Radiol 11(1):21–42PubMedCrossRefGoogle Scholar
  45. Sedat J, Chau Y, Razafidratsiva C, Bronsard N, de Peretti F (2010) One-stage percutaneous treatment in a patient with pelvic and vertebral compression fractures. Cardiovasc Interv Radiol 33(1):219–222CrossRefGoogle Scholar
  46. Seder CW, Kramer M, Uzieblo MR, Bove P (2009) Endovascular treatment of a superior mesenteric artery embolism in a high-risk Jehovah’s Witness. J Vasc Surg 49(4):1050–1052PubMedCrossRefGoogle Scholar
  47. Singh AK, Gervais DA, Alhilali LM, Hahn PF, Mueller PR (2006) Imaging-guided catheter drainage of abdominal collections with fistulous pancreaticobiliary communication. AJR Am J Roentgenol 187(6):1591–1596PubMedCrossRefGoogle Scholar
  48. Sofocleous CT, Hinrichs C, Hubbi B, Brountzos E, Kaul S, Kannarkat G, Bahramipour P, Barone A, Contractor DG, Shah T (2005) Angiographic findings and embolotherapy in renal arterial trauma. Cardiovasc Interv Radiol 28(1):39–47CrossRefGoogle Scholar
  49. Tapping CR, Byass OR, Cast JE (2011) Percutaneous transhepatic biliary drainage (PTBD) with or without stenting-complications, re-stent rate and a new risk stratification score. Eur Radiol 21(9):1948–1955PubMedCrossRefGoogle Scholar
  50. Tsalafoutas IA, Tsapaki V, Triantopoulou C, Gorantonaki A, Papailiou J (2007) CT-guided interventional procedures without CT fluoroscopy assistance: patient effective dose and absorbed dose considerations. AJR Am J Roentgenol 188(6):1479–1484PubMedCrossRefGoogle Scholar
  51. van Delden OM, Lameris JS (2008) Percutaneous drainage and stenting for palliation of malignant bile duct obstruction. Eur Radiol 18(3):448–456PubMedCrossRefGoogle Scholar
  52. van der Vlies CH, van Delden OM, Punt BJ, Ponsen KJ, Reekers JA, Goslings JC (2010) Literature review of the role of ultrasound, computed tomography, and transcatheter arterial embolization for the treatment of traumatic splenic injuries. Cardiovasc Interv Radio 33(6):1079–1087CrossRefGoogle Scholar
  53. Velmahos GC, Toutouzas K, Radin R, Chan L, Rhee P, Tillou A, Demetriades D (2003) High success with nonoperative management of blunt hepatic trauma: the liver is a sturdy organ. Arch Surg 138(5):475–480 discussion 80-1PubMedCrossRefGoogle Scholar
  54. Yamao Y, Yamakado K, Takaki H, Yamada T, Murashima S, Uraki J, Kodama H, Nagasawa N, Takeda K (2010) Optimal scan parameters for CT fluoroscopy in lung interventional radiologic procedures: relationship between radiation dose and image quality. Radiology 255(1):233–241PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Department of Clinical RadiologyClinical Center of the Ludwig-Maximilians-University of MunichMunichGermany
  2. 2.Department of Clinical RadiologyClinical Center of the Ludwig-Maximilians-University of MunichMunichGermany

Personalised recommendations