Interventional Radiology in the Older Patient
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Interventional Radiology in the Older Patient Dr Stuart Kerr Consultant Radiologist Mid Yorkshire NHS Trust
description
Interventional Radiology in the Older Patient. Dr Stuart Kerr Consultant Radiologist Mid Yorkshire NHS Trust. Dr Charles T Dotter, 1964. Dr Alfred Kratochwil, 1969. Subspecialisation. coronary → Cardiology neurological peripheral vascular non-vascular. Vascular Intervention. - PowerPoint PPT Presentation
Transcript of Interventional Radiology in the Older Patient
Interventional Radiology in the Older Patient
Dr Stuart KerrConsultant Radiologist
Mid Yorkshire NHS Trust
Dr Charles T Dotter, 1964 Dr Alfred Kratochwil, 1969
Subspecialisation
• coronary → Cardiology• neurological• peripheral vascular• non-vascular
Vascular Intervention
• diagnostic angiogram• angioplasty +/- stent for arterial stenosis• stent graft for aortic aneurysm/dissection• embolisation• IVC filter• SVC stent• Hickman / PICC lines
GI haemorrhage
• Endoscopy first• If negative, diagnostic CT angiogram
- DON’T DELAY!• Low threshold for speaking to Interventional
Radiologist
PICC line
chemotherapy
antibiotics
total parenteral nutrition
Non-vascular Intervention
Ultrasound v CT
• real-time visualisation• portable• quick• no radiation• frees up CT scanner
US-guided biopsy
Cholecystostomy
• indications- severe acute cholecystitis- not improving after 48 hours- gall bladder perforation
• tubogram at 6 weeks• ? percutaneous biliary stent
Percutaneous Transhepatic Cholangiography
Oesophageal stent
Pyloroduodenal stent
Colonic stent
Radiologically Inserted Gastrostomy (RIG)
Nephrostomy
Tumour ablation
• radiofrequency (RFA)• cryotherapy• microwave• chemical• transarterial embolisation /
chemoembolisation (TACE)
J Hepatol 2012;57:794
When things go wrong…..
Consent
Thank you
