Non Vascular Procedures


Interventional 1
Interventional 2
Interventional 3

Abscess Drainage


Abscess (sometimes referred to as a pus collection) is a cavity filled with pus and surrounded by the membrane of inflammatory tissue. Depending on its size and localization, it can be treated conservatively by antibiotics, by surgical excision or by insertion of drainage tube. Percutaneous tube placement is minimally invasive procedure, which results in shorter hospital stay and faster recovery period. As such, in well-considered cases it is advantageous compared to surgery.

Patient Q & A
What will happen?

Hospital admission is not a prerogative for the procedure, but as everybody is different, you may need to stay in hospital and the length of hospitalization may vary.

You will arrive into the Interventional Radiology Suite where the interventional radiologist (a doctor specially trained to perform this procedure) and radiographer will explain the procedure and answer your questions. The study usually takes about 60 minutes. After completion, you will be transferred to your ward or, if coming as an outpatient, monitored for 2 hours for possible complications.

Do I need any test before the procedure?

You will be asked to have following blood tests:

PI/FIT/Platelets — to assess the risk of post procedural bleeding.

You should discuss any allergy history (particularly to Iodine) with the radiologist prior to procedure.

The drainage procedure

You will have a drip placed in the arm for vascular access. Mild sedation might be required. You will be positioned on the X-ray table depending on the localization of the abscess and under local anesthesia and sterile conditions, a small incision will be made on your skin. The radiologist will use X-rays, ultrasound or CT to guide placement of drainage tube. Injection of contrast may be required to check the size of the abscess and confirm satisfactory position of the tube.

The catheter will be connected to a drainage bag and the insertion site will be covered with a dressing. You and/or the member of your family will be instructed about the bag care.

What will I feel? Does it hurt?

You will feel a bee sting when the doctor numbs the skin. You may feel some pressure and discomfort when the tube is inserted. We may need to give you extra medication to help you relax and to reduce your pain.

Some discomfort is to be expected in a few days after the tube insertion.

What are the risks?

Bleeding at the puncture site happens seldom and is usually minimal. In the unlikely case of arterial bleeding, surgical intervention or embolization may be necessary to control it.

After the procedure you may have a high fever with shivering which will be treated by antibiotics; it usually does not last more than few hours.

Allergic reaction to X ray contrast is very rare (moderate to serious reactions occur in 1/50.000

150.000 people). You should mention any allergy history to the radiologist in order to organize appropriate anti-allergic regime.

When will I get my results?

The radiologist will be able to talk to you immediately after the procedure.

When will I resume my normal activities?

It depends on your general condition. The radiologist and your attending physician/surgeon will give you proper advice.

Biliary Drainage and Stenting


Biliary drainage means placement of the soft plastic tube into the liver biliary ducts that are blocked usually by the stone or tumor. The purpose is to release pressure within the liver and avoid its damage as well as to prevent backflow of bile into the blood and consequent damage of the brain and other organs. The tube will allow the bile to pass around the blockage or to drain outside the body into the collection bag.

Patient Q & A
What will happen?

After hospital admission, you will arrive into the Interventional Radiology Suite where the interventional radiologist (a doctor specially trained to perform this procedure) and radiographer will explain the procedure and answer your questions. The study usually takes about 60-80 minutes. After completion, you will be transferred to your ward when you will be monitored. If no complication occurs, you may go home the following day. However, the discharge from the hospital will depend on your general health status and this will be decided by your attending physician or surgeon.

Do I need any test before the procedure?

You will be asked to have following blood tests:

PI/FIT/Platelets — to assess the risk of post procedural bleeding.

You should discuss any allergy history (particularly to Iodine) with the radiologist prior to booking biliary drainage.

Biliary drainage procedure

You will have a drip placed in the arm for vascular access. Mild sedation might be required. You will be lying on your back and under local anesthesia and sterile conditions, a small incision will be made on your skin. The radiologist will use X-rays and ultrasound to insert a thin needle into your liver. Contrast (x-ray dye) will be injected and drainage catheter will be inserted into your liver.

The catheter will be connected to a drainage bag and the insertion site will be covered with a dressing. The bile in the bag may contain some blood at first; however the blood usually clears with time.

You and/or the member of your family will be instructed about the bag care.

Biliary stenting procedure

The best time for the stent insertion is 48 hours after biliary drainage when the bile ducts in the liver are well decompressed. Under sterile conditions and local anesthesia the drain will be gently removed and over the guide wire, the metallic stent will be inserted at the site of narrowing to allow natural passage of the bile into the intestines. The drain will be reinserted, but will remain closed for the next 24-48 hours after which you will have the final injection of contrast. It will confirm that thestent is patent and the external drain will be removed.

What will I feel? Does it hurt?

You will feel a bee sting when the doctor numbs the skin. You may feel some pressure and discomfort when the tube or stent are inserted. We may need to give you extra medication to help you relax and to reduce your pain.

Some discomfort is to be expected for the first week after the tube insertion. Patients are usuallyunaware of the stent presence.

What are the risks?

Bleeding at the puncture site happens seldom and is usually minimal. In the unlikely case of arterial bleeding, surgical intervention or embolization may be necessary to control it.

Infection can be expected with prolonged procedure. We may need to give you antibiotics to prevent it.

Allergic reaction to X ray contrast is very rare (moderate to serious reactions occur in 1/50.000 — 150.000 people). You should mention any allergy history to the radiologist in order to organize appropriate anti-allergic regime.

Migration of the metallic stent is almost unknown; its position is carefully checked by the contrastinjection

When will I get my results?

The radiologist will be able to talk to you and the members of your family after the intervention andadvise if the procedure was technically successful.

When will I resume my normal activities?

If no complications occur, you will be able to get back to your normal life the next day – particularly if the stent is inserted and you are discharged without the tube. You will have to avoid any heavy physical activity while the tube is inserted and to take showers instead of a bath

Imaging Guided Biopsy


This technique is used to sample an abnormal area that has been detected either during a previous investigation or noticed clinically. Common areas submitted to biopsy are the lung, liver, kidney, thyroid, breast and soft tissue tumors.

Two most common types of biopsy are:
 
FINE NEEDLE ASPIRATION (FNA) means removing some cells from a suspicious lesion by a tiny hollow needle and examining them under a microscope. It involves a radiologist and a pathologist working as a team.

CORE BIOPSY means removing a piece of living tissue from an organ or other part of the body using a bigger spring loaded needle. It is usually performed by a radiologist but may sometimes involve a team consisting of a radiologist, surgeon and pathologist.

Sometimes the aspiration is performed to remove the fluid around the lung or from the abdomen in order to relieve the pressure. In that case it can be both diagnostic and therapeutic.

Patient Q & A
What will happen?

Hospital admission is not a prerogative for the procedure, but as everybody is different, you may need to stay in hospital and the length of hospitalization may vary.

You will arrive in the Radiology Department where the interventional radiologist (a doctor specially trained to perform this procedure) and radiographer will explain the procedure and answer your questions. The study usually takes about 30-60 minutes. After completion, you will be monitored for up to 3 hours for possible complications — depending on the part of your body that has been biopsied.

Do you need any test before the procedure?

You will be asked to have following blood tests:

PI/FIT/Platelets — to assess the risk of post procedural bleeding.

As in some cases we may need to give you contrast (X-ray dye), you should discuss any allergy history (particularly to Iodine) with the radiologist prior to booking a biopsy.

If you suffer from emphysema, we may ask you to have lung function tests before biopsy of the lung lesion — to assess if you will tolerate possible procedure related lung collapse.

The biopsy procedure

You will have a drip placed in the arm for vascular access. Mild sedation might be required. The radiologist will assess how to best visualize the lesion and accordingly decide whether to do it at the CT Scanner, Ultrasound, Mammography or Interventional Radiology Suite. Your skin will be sterilized and draped. The radiologist will apply local anesthetic and with a help of imaging place the needle into the tissue of interest and remove the sample.

What will I feel? Does it hurt?

You will feel a bee sting when the doctor numbs the skin. You may feel some pressure and discomfort when the needle is inserted. We may need to give you extra medication to help you relax and to reduce your pain.

What are the risks?

Bleeding at the biopsy site happens seldom and is usually minimal. In the unlikely case of arterial bleeding after core biopsy, surgical intervention or embolization may be necessary to control it.

The risk of infection is very low In a case of a lung nodule or mass biopsy, the air leak from the punctured lung may cause lung collapse (Pneumothorax). Sometimes it may necessitate placement of a chest tube in which case you will have to be admitted. The patients with the history of smoking and emphysema are at higher risk, but this complication is generally difficult to predict.

In a small number of cases, the obtained sample may not be adequate for the diagnosis. Theradiologist and your referring doctor will discuss alternative options with you (imaging follow-up orsurgical removal of the lesion).

When will I get my results?

The radiologist will be able to talk to you after the biopsy and advise if the procedure was a technicalsuccess. However, the pathological results usually take 12-24 hours in a case of FNA and even longer with Core biopsy. The final diagnosis will be presented to you only at your official appointment with referring doctor.

When will I resume my normal activities?

This varies depending on your general health condition and the location of the biopsied organ. In most cases, you may go back to your normal life the following day but the radiologist will let you know for sure.

Nephrostomy


Nephrostomy means placement of the soft plastic tube into the kidney which is blocked. The purpose is to release pressure within the kidney and prevent its destruction. It is sometimes performed to divert urine flow from the injured ureter and allow healing process.

Patient Q & A
What will happen?

Hospital admission is not a prerogative for the procedure, but as everybody is different, you may need to stay in hospital and the length of hospitalization may vary.

You will arrive in the Interventional Radiology Suite where the interventional radiologist (a doctor specially trained to perform this procedure) and radiographer will explain the procedure and answer your questions. The study usually takes about 60 minutes. After completion, you will be monitored for 2 hours for possible complications.

Do I need any test before the procedure?

You will be asked to have following blood tests:

PI/FIT/Platelets — to assess the risk of post procedural bleeding.

You should discuss any allergy history (particularly to Iodine) with the radiologist prior to booking a nephrostomy.

The nephrostomy procedure

You will have a drip placed in the arm for vascular access. Mild sedation might be required. You will be lying on your stomach and under local anesthesia and sterile conditions, a small incision will be made on your back. The radiologist will use X-rays and ultrasound to insert a needle into your kidney. Contrast (x-ray dye) will be injected and the nephrostomy catheter will be inserted into your kidney.

The catheter will be connected to a drainage bag and the insertion site will be covered with a dressing. The urine in the bag may contain some blood at first; however the blood usually clears with time.

You and/or the member of your family will be instructed about the bag care.

Does it hurt?

You will feel a bee sting when the doctor numbs the skin. You may feel some pressure and discomfort when the tube is inserted. We may need to give you extra medication to help you relax and to reduce your pain.

Some discomfort is to be expected for the first week after the tube insertion.

What are the risks?

Bleeding at the puncture site happens seldom and is usually minimal. In the unlikely case of arterialbleeding, surgical intervention or embolization may be necessary to control it.

Infection can be expected with prolonged procedure. We may need to give you antibiotics toprevent it.

Allergic reaction to X ray contrast is very rare (moderate to serious reactions occur in 1/50.000 — 150.000 people). You should mention any allergy history to the radiologist in order to organize appropriate anti-allergic regime.

When will I get my results?

The radiologist will be able to talk to you after the procedure, but all the relevant details will only be available at your official appointment with referring doctor.

When will I resume my normal activities?

If no complications occur, you will be able to get back to your normal life the next day. You will have to avoid any heavy physical activity while the tube is inserted and to take showe

Ureteric Stent Placement


Ureteric stent is a plastic tube that restores the urine flow from the kidney to urinary bladder through the blocked ureter. Like nephrostomy, it will relieve the pressure in the kidney and prevent its damage. The common cause for the blockage is stone and rarely scar or tumor. The procedure is performed either by the urologist through the bladder, or by the radiologist through the kidney.

Patient Q & A
What will happen?

Hospital admission is not a prerogative for the procedure, but as everybody is different, you may need to stay in hospital and the length of hospitalization may vary.

You will arrive in the Interventional Radiology Suite where the interventional radiologist (a doctor specially trained to perform this procedure) and radiographer will explain the procedure and answer your questions. The study usually takes about 60 minutes but may take longer if the blockage is severe. After completion, you will be monitored for 2 hours for possible complications or transferred to your ward.

Do I need any test before the procedure?

You will be asked to have following blood tests:

PI/FIT/Platelets —to assess the risk of post procedural bleeding.

You should discuss any allergy history (particularly to Iodine) with the radiologist prior to procedure.

The stent placement procedure

You will have a drip placed in the arm for vascular access. Mild sedation might be required. You will be lying on your stomach and under local anesthesia and sterile conditions, a small incision will be made on your back. The radiologist will use X-rays and ultrasound to insert a needle into your kidney. Contrast (x-ray dye) will be injected and the stent will be inserted through your kidney. Nephrostomv tube will be also inserted in your kidney but will remain closed for 24-48 hours after which you will have the final control. Injection of contrast will confirm that the stent is patent andthe tube will be removed.

What will I feel? Does it hurt?

You will feel a bee sting when the doctor numbs the skin. You may feel some pressure and discomfort when the tube is inserted. We may need to give you extra medication to help you relax and to reduce your pain.

What are the risks?

Bleeding at the puncture site happens seldom and is usually minimal. In the unlikely case of arterial bleeding, surgical intervention or embolization may be necessary to control it.

Infection can be expected with prolonged procedure. We may need to give you antibiotics to prevent it.

Allergic reaction to X ray contrast is very rare (moderate to serious reactions occur in 1/50.000 — 150.000 people). You should mention any allergy history to the radiologist in order to organize appropriate anti-allergic regime.

When will I get my results?

The radiologist will be able to talk to you after the procedure, but all the relevant details will only be available at your official appointment with referring urologist. He will also advice you for how long you will need stent and will organize its removal in theatre.

When will I resume my normal activities?

If no complications occur, you will be able to get back to your normal life the next day after nephrostomy tube is removed.