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Interventional Radiology in the Older Patient. Dr Stuart Kerr Consultant Radiologist Mid Yorkshire NHS Trust. Dr Charles T Dotter, 1964. Dr Alfred Kratochwil, 1969. Subspecialisation. coronary → Cardiology neurological peripheral vascular non-vascular. Vascular Intervention.
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Interventional Radiology in the Older Patient Dr Stuart Kerr Consultant Radiologist Mid Yorkshire NHS Trust
Dr Charles T Dotter, 1964 Dr Alfred Kratochwil, 1969
Subspecialisation • coronary → Cardiology • neurological • peripheral vascular • non-vascular
Vascular Intervention • diagnostic angiogram • angioplasty +/- stent for arterial stenosis • stent graft for aortic aneurysm/dissection • embolisation • IVC filter • SVC stent • Hickman / PICC lines
GI haemorrhage • Endoscopy first • If negative, diagnostic CT angiogram - DON’T DELAY! • Low threshold for speaking to Interventional Radiologist
PICC line chemotherapy antibiotics total parenteral nutrition
Ultrasound v CT • real-time visualisation • portable • quick • no radiation • frees up CT scanner
Cholecystostomy • indications - severe acute cholecystitis - not improving after 48 hours - gall bladder perforation • tubogram at 6 weeks • ? percutaneous biliary stent
Tumour ablation • radiofrequency (RFA) • cryotherapy • microwave • chemical • transarterial embolisation / chemoembolisation (TACE)