Clinton Memorial Hospital

1. Clinton Memorial Hospital Interventional Radiology

2. 21st Century Medicine “Best kept secret in medicine” Minimally invasive procedures Diagnosis Treatment Targeted therapies Using imaging for guidance What is Interventional Radiology

3. Advantages of Interventional Radiology • Minimally invasive alternative to many surgical procedures • Most procedures can be performed on an outpatient basis or overnight hospital stay • General anesthesia typically not required • Risks, pain and recovery time are often significantly reduced compared to surgery

4. Types of Procedures • Diagnostic • Therapeutic • Vascular Intervention • Non-Vascular Intervention

5. Benefits of Non-Invasive Diagnosis • Prevention of catastrophic vascular events • Availability • Quality • Safety • Guide triage of patients • Appropriate therapy • Timely management • Success of interventions • Follow up of disease/therapy

6. Arterial Interventions • Angiography • Angioplasty • Stent placement • Stent-graft placement • Thrombectomy/thrombolysis • Embolization • Atherectomy

7. Venous Interventions • Venography • Venoplasty • Stent placement • Thrombectomy/throbolysis • Hemodialysis Access Management • Transjugular Intrahepatic Portosystemic Shunt • Central Venous Access • Treatment of Venous Insufficiency • Caval Filtration

8. Interventional Oncology • Tailored cancer treatments • Targeted cancer therapies • Thermal ablation treatments Radiofrequency ablation Cryoablation • Chemoembolization • Delivered directly to the tumor • Minimize side effects • Less damage to normal tissues • Improve patients’ quality of life • Rapidly increasing number of indications for treatment

9. Thermal Ablation Treatments • Radiofrequency ablation • Probe inserted into tumor through the skin • Localized treatment that kills the tumor cells with heat • Does not significantly affect patient’s overall health • Spares healthy tissues • Much easier on the patient than chemotherapy or surgery • Dead tumor shrinks to form scar tissue • Cryoablation • Localized treatment that kills the tumor cells with cold gases causing it to freeze

10. Thermal Ablation Treatments • Beneficial for many patients • Survival benefit in some • Palliative benefit in many • Relief of pain and other debilitating symptoms • Increases disease-free interval • Delay additional, more aggressive, forms of chemotherapy • Can be repeated if necessary • May be combined with other therapies • Very well tolerated by most patients

11. Vertebroplasty • Minimally invasive procedure in which acrylic bone cement is injected into a pathologically compressed vertebral body • To provide relief from a vertebral pain source that is associated with a pathologic vertebral compression fracture. • Osteoporosis • Primary or Secondary • Neoplasm • Benign or Malignant

12. Benefits Pain relief Quick Complete Improved mobility Patient able to stand and walk first 24 hours Mechanism of action Stabilization of fracture Prevents further collapse of the treated vertebral body Destruction of nerve fibers Vertebroplasty

13. Endovenous Laser TreatmentEVLT • Varicose Vein Treatment • Laser energy is used to heat the vein wall, shrinking and closing the damaged vein so blood can no longer flow through it. • Alternative to traditional Vein Stripping • Utilizes ultrasound guidance and x-ray guidance

14. EVLT • Varicose Vein: • Caused by faulty valves and weakened vein walls • Symptoms: • Swelling • Rashes/itchiness • Numbness/heaviness • Aching/throbbing • Benefits • Treatment in less than an hour • Minimal to no scarring • Resume normal activity the same day

15. CMH Interventional Radiology • Wide variety of minimally invasive therapies • Multiple new revolutionary technologies • Future of medical care