April 2015

Interventional Radiology: A Path Less Travelled

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Dr Ajit Yadav

Dr Ajit Yadav,
Consultant, Department of
Interventional Radiology, Sir Ganga
Ram Hospital

Interventional radiology (IR) is a medical sub-specialty of radiology utilising minimally-invasive image-guided procedures to diagnose and treat diseases. The range of diseases and organs amenable to image- guided therapeutic and diagnostic procedures are extensive and constantly evolving and mainly involving vascular, gastrointestinal, hepatobiliary, genitourinary, pulmonary, musculoskeletal, and the central nervous system. As part of IR practice, interventional radiologist provide patient evaluation and management relevant to image-guided interventions in collaboration with other specialists or independently. These procedures are less invasive than open surgery, therefore recovery is faster and generally less discomfort and fewer associated complications.

In the last decade, IR practice was limited to hospitals in New Delhi, Mumbai, Trivandrum and Lucknow but over the years there has been an expansion in the practice of IR in India as a whole.

In last few years there has been a gradual and steady growth of Interventional Radiology. If we had to evaluate growth of Interventional Radiology in India then we can see it is because increasing demands from referring physicians, the widespread availability of imaging equipment for guided procedures, IR’s potential to serve as a convenient alternative to open surgical procedures and reduce recovery time, and the tremendous advances in IR hardware.

Today, IR is an integral part of various clinical procedures, finding a role in peripheral vascular diseases like varicose vein and occlusive diseases. Neuro-interventions include stroke management and presurgical tumour embolisation. Interventional radiology also have special role in oncology like transarterial chemo and radio-embolisation in hepatocellular carcinoma, RFA in various malignancies. Uterine fibroid embolisation, prostatic artery embolisation and angio embolisation for bleeding are few of IR procedures, by which major surgery can be avoided.

When we look at the future of IR in India, there are two challenges that should be addressed. The first is the need for vigorous efforts for the motivation of students and radiology residents in all the leading Indian medical institutions so that we can create a second rung of specialists who can gradually step into the shoes of the current practitioners.

The second challenge is to reduce the cost of hardware. Most of catheterscoils and vascular stents are manufactured in USA and Europe and imported in India, increasing the cost of procedure and limit these minimally invasive procedure to private/corporate healthcare sector. We need to raise our manufacturing standard and follow the new formula of our government “Make in India’’ to reduce the cost of hardware, then only we can make IR treatment affordable to our peoples.

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