INTERVENTIONAL RADIOLOGY

APPLICATIONS OF INTERVENTIONAL RADIOLOGY

The percutaneous ablation of tumors

The percutaneous ablation of lung tumors is a relatively new therapeutic method. With the direction of the CT scanner, a needle is transdermally inserted in the tumor. The radiofrequency channeled through the needle is applied on the tumor, causing high temperatures and thus achieving the controlled coagulative necrosis of the tumor.  Although the treatment of lung cancer in early stages is surgical, there are cases where, due to other concomitant medical problems, patients cannot be operated. Moreover, alternative therapeutic methods are sought for patients with more advanced cancer that don't respond to chemotherapy or radiation. Patients with limited metastatic lung cancer, who cannot be operated for other reasons, constitute a frequent medical problem. All the abovementioned patient groups are candidates for transdermal tumor ablation.

Local intra-arterial chemotherapy

Local intra-arterial chemotherapy for lung cancer up to metastatic stages is also an important therapy method for selected cases. With the above method and by arterial catheterization doctors administer chemotherapeutic drugs and embolic material locally on the tumor. So with smaller drug doses we achieve higher efficacy, avoiding generalized toxic side effects, even the tumor's ischemia that will lead to its minimization and possible elimination.

Drainage of abscess collection

Over the past two decades, the transdermal drainage of abscess collections from the body has replaced the, formerly used, surgical drainage. Transdermal drainage is achieved with the help of catheters under radiological monitoring, usually by the CT, with great accuracy, very high success rates and minimal complications.

In the Department of Interventional Radiology, the transdermal drainage of abscess collections is carried out with absolute success and is considered a routine operation. Hospitalization lasts one day or even a few hours and if there is no complication, the patient can return home.

Intra-arterial embolization

Intra-arterial embolization is a non-surgical, minimally invasive procedure targeting the selective occlusion of the blood vessels, mainly arteries, for therapeutic purposes. In medical science, the method of embolization is used to treat a variety of conditions.

Numerous successful embolizations are performed in our clinic to treat benign conditions, such as arteriovenous malformations (e.g. hemangiomas, hemangiomas with lipomas), peripheral angiodysplasia (e.g. Klippel-Trenaunay-Weber syndrome), treatment of bleeding of upper and lower digestive tract (whether from benign or malignant causes) and for the treatment of malignant tumors (e.g. sarcomas, melanomas, kidney tumors, lung tumors, endometrium tumors, soft tissue tumors, etc.).

Chemoembolization of malignant liver tumors

The intra-arterial chemoembolization is a method that achieves the transfer of high concentrations of chemotherapeutic drugs directly to the tumor through a transdermal, intra-arterial catheter and the ischemia and necrosis of the tumor, through the embolization of its feeding arteries.

Intra-arterial chemoembolization is generally well tolerated and serious complications are extremely rare. The most common side effect is called "post-embolization syndrome". However this syndrome is usually transient and the patient recovers within a few days. Most patients can return to their home one day after the procedure of chemoembolization. Side effects, such as hair loss and bone marrow suppression, which are common after systemic chemotherapy, do not occur after the intra-arterial chemoembolization.

Our clinic is visited for chemoembolization by patients with primary liver tumors (hepatocellular carcinoma, cholangiocarcinoma) or secondary liver metastases from other tumors (colorectal carcinoma, lung cancer, breast cancer, neuroendocrine tumors, kidney cancer, sarcoma, melanoma, soft tissue tumors, etc.).

Bile vessels drainage - Bile vessels angioplasty (Stent)

Often enough, liver tumors are so sizable that compress and occlude the bile vessels or even invade them, resulting in the blockage of the bile. The bile then stagnates, causing toxic effects to the body, which can be fatal.

The drainage of the bile vessels in such cases must be done immediately, either simultaneously to the outside and to the intestine or -if possible- only outwardly with the help of a catheter (external drainage).

In cases where there is a blockage and a stent should be inserted, the vessels' patency can be ensured with angioplasty. The usual process includes the initial dilatation of the blocked or stenosed section of the vessels with a balloon and then the insertion of the stent.

Access in all cases is achieved transdermally and hospitalization lasts one day. Bile vessels drainage by catheters both external or internal, as well as angioplasty procedures with stent insertion are frequently performed in our clinic with very high success rates.

Metastatic liver diseas

Liver is susceptible to cancer metastases, through the blood tract, particularly of the gastrointestinal system. The surgical treatment of the tumors is not always feasible, while systemic chemotherapy doesn't always generate the liver's expected response. In many of those cases, it is suggested to implement an intra-arterial chemo-embolization, in order to address the secondary foci in the liver. And this method has proved to generate very encouraging results.

Intra-arterial chemo-embolization for liver metastases are frequently performed in the Interbalkan Medical Center, with the administration of chemotherapeutic agents which are well tolerated by patients. Liver metastases may be derived from colon, lung, kidney, breast, pancreas, stomach, or ovarian cancer or from melanomas, sarcomas, neuroendocrine tumors, soft tissue tumors, etc. Hospitalization usually lasts one day and then the patient can return home. The final result depends on many factors, including the type of the primary tumor, the number and size of tumor foci, its localization, the overall health of the patient, the repeatability of the chemoembolization etc.