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