Interventional Radiology

Prof. Dr. Zekai Pekkafalı

General Interventional Radiology

1. **Vascular Interventions**
   - Angioplasty and Stenting
   - Embolization (e.g., for aneurysms, tumors)
   - Thrombolysis
   - Varicocele Embolization
   - Inferior Vena Cava (IVC) Filter Placement and Removal
   - Carotid Artery Stenting

2. **Oncological Interventions**
   - Chemoembolization (e.g., Transarterial Chemoembolization, TACE)
   - Radioembolization (e.g., Yttrium-90, SIRT)
   - Tumor Ablation Techniques
     - Radiofrequency Ablation (RFA)
     - Microwave Ablation (MWA)
     - Cryoablation

3. **Non-Vascular Interventions**
   - Biopsies (e.g., liver, lung, kidney)
   - Drainage Procedures (e.g., abscess, bile duct, nephrostomy)
   - Gastrostomy Tube Placement
   - Vertebroplasty and Kyphoplasty
   - Pain Management (e.g., nerve blocks, epidural injections)

Pediatric Interventional Radiology

1. **Vascular Interventions**
   - Central Venous Access (e.g., PICC lines, port-a-cath)
   - Arteriovenous Malformations (AVM) Embolization
   - Venous Malformations Treatment
   - Dialysis Access Procedures

2. **Oncological Interventions**
   - Tumor Ablation Techniques in Pediatric Patients
   - Embolization of Pediatric Tumors

3. **Non-Vascular Interventions**
   - Pediatric Biopsies
   - Drainage Procedures in Pediatrics
   - Gastrostomy and Jejunostomy Tube Placement
   - Treatment of Pediatric Osteoid Osteoma and Similar Conditions

4. **Special Pediatric Interventions**
   - Management of Congenital Anomalies (e.g., vascular malformations)
   - Treatment of Pediatric Renal Disorders (e.g., nephrostomy)

Specific Treatments/Interventions

1. **Radiofrequency Ablation (RFA) for Osteoid Osteoma**
   - **Indication**: Osteoid Osteoma, a benign but painful bone tumor commonly found in children and young adults.
   - **Procedure**:
     - Imaging Guidance: Use of CT or fluoroscopy for precise targeting.
     - Needle Insertion: A needle electrode is inserted into the tumor.
     - Ablation: High-frequency electrical currents are passed through the electrode to heat and destroy the tumor cells.
     - Post-Procedure Care: Monitoring for complications, pain management, and follow-up imaging.

2. **RFA and Similar Techniques for Other Conditions**
   - **Osteoid Osteoma**: As described above.
   - **Osteoblastoma**: Larger and less common benign bone tumor, treated similarly to osteoid osteoma but may require more extensive ablation or surgical intervention.
   - **Metastatic Bone Disease**: Palliative treatment to reduce pain and improve quality of life.
   - **Bone Cysts**: Ablation combined with bone cement augmentation.

3. **Additional Tumor Ablation Techniques**
   - **Microwave Ablation (MWA)**: Similar to RFA but uses microwave energy to generate heat.
   - **Cryoablation**: Uses extreme cold to freeze and destroy tumor cells, useful for certain soft tissue and bone tumors.

Imaging Techniques and Modalities

1. **Ultrasound**: Used for real-time guidance in procedures like biopsies and drainages.
2. **Computed Tomography (CT)**: Essential for precise localization in ablation procedures and biopsies.
3. **Magnetic Resonance Imaging (MRI)**: Used for detailed soft tissue characterization and guiding certain interventions.
4. **Fluoroscopy**: Dynamic imaging for vascular procedures, drainage, and other interventions.

Diagnostic Procedures

1. **Angiography**: Imaging of blood vessels to diagnose and guide treatments.
2. **Venography**: Imaging of veins to diagnose conditions like deep vein thrombosis.
3. **CT/MR Angiography**: Non-invasive imaging of blood vessels.