medical tourism, adenomyosis,Interventional Radiology India,Interventional Radiology Delhi,Fibroid embolization India,Fibroid embolization Delhi
 
Dr. Pradeep Muley M.D.
email:fibroid@indianinterventionalradiology.in
muleypradeep@hotmail.com
Mobile:+91-9810492778

 Hepatobilliary (Non vascular and vascular)

 Types of image-guided radiological interventions available:-
  1. Image guided Liver Biopsy.
  2. Transjugular Liver Biopsy.
  3. Percutanous transhepatic cholangiography & drainage.
  4. Percutanous transhepatic CBD stenting.
  5. Post-operative cystic duct interventions.
  6. RFA.
  7. Trans-arterial Chemo-embolization for hepatic tumor/ Mets.
  8. Intra-arterial chemotherapy for liver tumor.
  9. Trans-arterial I-131 for hepatic tumors.
  10. Portal vein embolization.
  11. Arterio-portogram.
  12. TIPS–Transjugular Intrahepatic Portosystemic Shunt.
  13. Embolization for aneurysm/psudo-aneurysm related to liver & spleen
  14. GI-bleed.
 Image guided Liver Biopsy – FNAC
 Indication
        Liver mass suspected of being malignant
        Hepatitis C
        progressive diffuse liver disease
        Liver transplant protocol

 Contraindications
        relative contraindications include suspected hemangioma and ascities

 Pre procedure things to check
        Nil by mouth 4-6 hrs prior to procedure, Bleeding history, INR, Platelets and stop aspirin for a week.

 Transjugular liver biopsy
• Liver biopsy in patients C/I or high risk for percutaneous biopsy due to coagulopathy or thrombocytopinea or massive ascites.
• Pre-op evaluation of liver transplant candidates.
• Diffuse liver disease.

prostate problems, prostate surgery,Renal angioplasty,Carotid artery stenting,CBD stenting,Percntanous nephrostomy prostate problems, prostate surgery,Abscess drainage,Haemodialysis access management,lower limb angioplasty
 prostate problems, prostate surgery, Abscess drainage,Haemodialysis access management,lower limb angioplasty

 Biliary Drainage (percutaneous biliary drainage)
 Indication :
    • Malignant biliary obstruction with unsuccessful attempt at ERCP
    • Previous intestinal surgery which precludes ERCP
    • Benign biliary obstruction with unsuccessful attempt at ERCP

 Percutaneous access to biliary system can be used for :
    • Placement of drainage catheter.
    • Metal stent
    • Stone removal
    • Radiation Brachytherapy.
    • Endoluminal biopsy.

 Two types of biliary drain
A. External Biliary Drain (E-BD)
• Electrolytes are lost in bile that is drained, and need to be replaced orally or intravenously (lacated Ringer’s intravenous fluid)
• External drainage is not a first choice of drainage because extra work, discomfort for patient associated with daily catheter care and loss of bile salts.

B. Internal -External Biliary Drain (IE-BD)
• Internal component drain proximal and distal to site of obstruction and a locking loop for securing catheter in duodenum.
• External component maintains percutaneous access to biliary system which facilitates performance of subsequent procedures.

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 Common Problemes & Complications
• Pain
• Skin site infection if long standing
• Bleeding or hemobilia
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Marked stenosis of lower CBD 		prostate gland enlargement treatment,AVM embolization,RFA/Liver/Lung/kidney tumor,Fibroid Club India
Balloon dilatation stenosis of CBD
prostate gland enlargement treatment
ERCP stent blocled, later B/L External- 		prostate gland enlargement treatment, AVM embolization,RFA/Liver/Lung/kidney tumor,Fibroid Club India
Internal biliary drainage was performed.
 CBD Stenting
Intracranial anerysum coilling,Bronchial artery embolization,Haemangioma embolization prostate gland enlargement treatment,Intracranial anerysum coilling,Bronchial artery embolization,Haemangioma embolization

 High Grade Hilar Stricture Secondary To Klatskin Tumour
prostate gland enlargement treatment,Pradeep muley, Interventional radiologist prostate gland enlargement treatment,Pradeep muley, Interventional radiologist prostate gland enlargement treatment,GI bleed embolization,Post partum hemorrhage embolization,Post delivery bleeding

 GI Bleeding
Renal angioplasty,Carotid artery stenting,CBD stenting,Percntanous nephrostomy Renal angioplasty,Carotid artery stenting,CBD stenting,Percntanous nephrostomy Coiling of psuedoaneurysm Renal angioplasty,Carotid artery stenting,CBD stenting,Percntanous nephrostomy

 TIPS(Transjugular Intrahepatic Portosystemic Shunt)

Cirrhotic patients who survive an episode of bleeding from esophageal varices have an extremely high risk of rebleeding.

For this reason, pharmacological therapy and endoscopic injection sclerotherapy are the most widely used treatments.

Both treatments are not fully satisfactory, as the average rebleeding rate with each therapy is about 48%.


 Indication for TIPS
An acute variceal hemorrhage uncontrolled by medical and endoscopic treatment.
Preventing rebleeding in patients in whom sclerotherapy failed.
Refractory ascites.
Budd-Chiari Syndrome.
Patients who bleed while awaiting liver transplantation.
Abscess drainage,Haemodialysis access management,lower limb angioplasty
Fig A. Portal Hypertension before the TIPS procedure is performed 		Abscess drainage,Haemodialysis access management,lower limb angioplasty
Fig B. After the TIPS procedure is performed

 TIPS (Transjugular Intrahepatic Portosystemic Shunt)
Interventional Radiology India,Interventional Radiology Delhi,Fibroid embolization India,Fibroid embolization Delhi AVM embolization,RFA/Liver/Lung/kidney tumor,Fibroid Club India HCC embolization,RFA Varicose vein
Intracranial anerysum coilling,Bronchial artery embolization,Haemangioma embolization Intracranial anerysum coilling,Bronchial artery embolization,Haemangioma embolization GI bleed embolization,Post partum hemorrhage embolization,Post delivery bleeding
Interventional Radiology India,Interventional Radiology Delhi,Fibroid embolization India,Fibroid embolization Delhi Abscess drainage,Haemodialysis access management,lower limb angioplasty Abscess drainage,Haemodialysis access management,lower limb angioplasty

 TIPS
Interventional Radiology India,Interventional Radiology Delhi,Fibroid embolization India,Fibroid embolization Delhi AVM embolization,RFA/Liver/Lung/kidney tumor,Fibroid Club India Intracranial anerysum coilling,Bronchial artery embolization,Haemangioma embolization
Renal angioplasty,Carotid artery stenting,CBD stenting,Percntanous nephrostomy Abscess drainage,Haemodialysis access management,lower limb angioplasty Abscess drainage,Haemodialysis access management,lower limb angioplasty