Interventional radiological procedure has an overall advantage over surgical procedures for the patient as the body part is not removed says Dr Pradeep Muley, Head & Senior Consultant Interventional Radiologist,Fortis Hospital, Vasant Kunj, New Delhi

What have been the most notable achievements in interventional radiology in the last decade?
Interventional radiologists are specialists who use various imaging and catheterisation techniques in order to diagnose and treat vascular issues in the body. Interventionalist techniques include injecting arteries with dye,visualising these via x-ray, and opening up blockages. The rapid new development of imaging technologies, mechanical devices, and types of treatment,have certainly been beneficial to the patient and without surgery various diseases can be treated like uterine fibroids, uterine adenomyosis, opening of blocked fallopian tubes, varicocele,chronic pelvic pain (pelvic congestion syndrome), varicose vein in leg, opening of blocked arteries, bleeding from mouth due to tuberculosis in chest.The most recent development is treating enlarged prostate by non “surgical method called as prostatic artery embolisation.

What are the benefits of interventional radiology over traditional surgery?
Interventional radiology is performed under local anesthesia. It requires only a tiny niche in the skin and no surgical incision of abdomen is done.Recovery period is very short than from any open surgery. Virtually no adhesion or scar formation has been found. But in surgery adhesions are common. Using interventional radiology even two medical problems can be treated in one sitting. It is less expensive than surgery; it ensures short stay at the hospital. Emotionally financially and physically “ interventional radiological procedure have an overall advantage over surgical procedures for the patient as the body part is not removed.

What are the challenges in its advancement as a medical sphere? What are the measures to overcome them?
The development of Interventional Radiology leads to tug – war between surgeon and interventional radiologist. If patient has uterine fibroids,the gynecologist offers only removal of uterus not the non-surgical method called uterine artery embolisation.While these practitioners can be in competition with each other, cooperation and communication are the most advantageous methods to deal with these turf wars. All of the intech terventionalists are needed to deliver the best medical care to patients, now and in the future.

Since when has Fortis hospital,Vasant Kunj, Delhi been operating an interventional radiology department and what issues does it address?
The Interventional Radiology department is my brain child and since its inception in 2005 I have been taking care of the entire function here. I am assisted by a team of trained nurses and practicing radiologists. Having done my specialisation in Body & Neuro-interventional radiology from KE M Hospital Mumbai, AIIMS, Delhi, Johns Hopkins Medical Institute, USA and Singapore General Hospital, I wanted to device techniques which required minimal surgery and takes less of patients time in hospital. Through the technique of Interventional Radiology,I am using a number of techniques here including uterine artery embolisation for fibroid/adenomyosis,varicose vein, infertility treatment for opening of blocked fallopian tube, varicocele,enlargement prostate, bronchial artery embolisation for bleeding lungs, chemo embolisation of liver tumor, lower limb blockage of artery.

Technology Snapshot:The interventional radiologist makes a small nick in the skin (less than a centimeter) at groin, inserts a catheter,identifies blockedartery by using angiography with contrast medium injection and then use balloon or inject embolisation particles (polyvinyl alcohol) that block the tiny vessels or open a diseased artery by balloon

How is interventional radiology a very effective way to treat varicose vein? How is it better than other means of treatment?
Varicose vein of legs is common, affecting 1-15 percent of adult men and 20-25 percent of adult women. The most common symptoms are pain,swelling, heaviness in leg, fatigue,prominent and dilated veins in leg veins and some time venous ulcer. The diagnosis is done by general examination and ultrasound Doppler study which can show the exact site of disease in the form of damaged valves and dilatation of veins.
The Radiofrequency Ablation (RFA) is the latest and most effective, patient friendly and non-surgical treatment for varicose vein using RFA machine. Under Doppler ultrasound vision, a radiofrequency catheter is inserted into the abnormal vein and the vessel treated with radio-energy, resulting in closure of the involved vein causing collapse of the thick veins. This non-surgical treatment is better than any surgical treatment.

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