Do you know about interventional therapy?

Interventional therapy, which can be simply understood as an emerging treatment method between surgical and medical treatment, includes intravascular intervention and non-vascular intervention. Simply speaking, interventional therapy is the least invasive treatment method to treat the lesion locally under the guidance of imaging equipment (angiography, fluoroscopy, CT, MR, B ultrasound) through tiny channels of a few millimeters in diameter in blood vessels or skin, or through the body’s original pipeline, without opening the lesion to expose it. After years of development, interventional therapy has become one of the three pillar disciplines along with surgery and internal medicine. The characteristics of interventional treatment are: less invasive, simple, safe, effective, less complications and significantly shorter hospital stay. 1.Commonly used techniques are divided into: intravascular interventions and non-intravascular interventions according to the path of the device into the lesion. Endovascular intervention refers to: using 18G-20G puncture needles, entering the human vascular system by puncturing the superficial arteries or veins of the human body, delivering the catheter to the location of the lesion under the guidance of the angiography machine, injecting the contrast agent through the catheter, showing the vascular situation of the lesion, and treating the lesion in the blood vessel. These include: arterial embolization, angioplasty, etc. Commonly used body surface puncture points are femoral artery, radial artery, subclavian artery, jugular artery, etc. Non-vascular intervention refers to: simply speaking, it is a method of accessing the natural lumen system of the human body through the body surface, directly puncturing through the skin to the lesion under the monitoring of imaging equipment, or entering the lesion through the human embodied channel, and removing the tissue from the lesion for diagnosis/ or treatment. These include: percutaneous tube drainage and stent implantation for biliary obstruction; endogastric stent implantation; percutaneous puncture biopsy, intratumoral injection, disc puncture decompression, disc puncture ablation; radioactive particle implantation, etc. In addition, there are treatments that use a puncture needle to puncture directly through the body surface to the artery supplying blood to the lesion. For the time being, they are classified as non-vascular interventions. (1) Embolization of tumors: Tumors of liver, lung and pelvis can be treated by injecting embolic agents into the blood supply arteries through catheters to block their blood flow and achieve the purpose of “starving the tumor”. (2) Embolization of bleeding: late stage tumors often cause hemorrhage, which often leads to other complications and death if not controlled in time. For example, lung cancer, bladder cancer, rupture of esophageal varices in the fundus of stomach, etc. Such patients should undergo emergency intervention to embolize their blood supply vessels to control bleeding. In addition, such as spontaneous bleeding from blood-rich tumors, nasopharyngeal fibrovascular tumors; hemostatic treatment of post-surgical abdominal bleeding; ectopic pregnancy or postpartum bleeding; are common conditions for emergency interventions. (3) Inhibit functional embolization: partial splenic embolization is feasible for splenomegaly accompanied by hypersplenism; action pulse embolization can inhibit hyperplasia and eliminate symptoms in prostate hyperplasia; (4) Intracavitary thrombolytic therapy: can be used for arterial or intravenous thrombosis. (2) Stenting techniques: (1) endoluminal molding: with the maturity of technology and the development of new surgical instruments, endoluminal molding is more and more widely used; aortic coarctation, abdominal aortic aneurysm, arterial stenosis, diabetic foot, etc., most patients can avoid surgical treatment. (2) Esophageal and digestive tract stent: When patients with advanced esophageal cancer have difficulty in eating, esophageal stent can be placed into the lesion through oropharynx to improve the patient’s eating condition, and at the same time, the stent has a certain compression effect on the tumor, causing tumor ischemia and slowing down tumor growth. In recent years, there are radioactive stents used clinically to perform internal irradiation treatment while dilating the esophagus to shape. In addition, there are also duodenal stents and colonic stents for tumor-induced gastrointestinal stenosis. (3) Biliary stents: Suitable for obstructive jaundice caused by tumors in the hilar and pancreatic areas compressing the bile ducts, percutaneous liver puncture is taken and biliary stents are placed in the stenotic segment so that bile can enter the duodenum directly, which is the preferred method to solve obstructive jaundice. Artificial lumpectomy: Transjugular intrahepatic portosystemic shunt (TIPS): for cirrhotic portal hypertension; 3. Characteristics of interventional treatment Convenience, safety, effectiveness, minimally invasive and few complications are the main characteristics of interventional treatment. To a certain extent, interventional therapy = surgery without incision. The advantages are: (1) It does not require an incision and has a quick recovery after surgery. (2) Less damage, faster recovery, better results, less disturbance to the body, and protection of normal organs to the greatest extent. (3) For malignant tumors for which there is no cure, interventional therapy can confine the drugs to the lesion as much as possible, while reducing the side effects on the body and other organs. (4) Interventional treatment requires only local anesthesia and has few side effects, which makes it more suitable for old and weak patients. (5) The success rate of the procedure is high and the mortality rate is low. According to relevant statistics, the success rate of interventional treatment is as high as 90% and the mortality rate is almost zero. Because of these advantages, many interventional treatments have become one of the most important treatment methods for certain diseases (e.g. liver cancer, lung cancer, aneurysm, vascular malformation, uterine fibroids, lumbar disc herniation, etc.), even replacing or eliminating the original surgical procedures.