Interventional therapy is an emerging treatment method between surgical and medical treatment, including intravascular interventions and non-vascular interventions. After more than 30 years of development, it is now known as one of the three pillar disciplines along with surgery and internal medicine. Simply put, interventional therapy is the least invasive treatment method that involves making tiny channels of a few millimeters in diameter in blood vessels and skin or through the body’s original ducts to treat the lesion locally under the guidance of imaging equipment (angiography, fluoroscopy, CT, MR, B ultrasound) without opening an incision to expose the lesion.
Advantages.
Interventional treatment is characterized by small trauma, simplicity, safety, effectiveness, few complications and significantly shorter hospital stay.
I. For diseases requiring medical treatment, the advantages of interventional therapy compared with medical treatment are.
Drugs can be directly applied to the lesion, which not only can greatly increase the concentration of drugs in the lesion, but also can greatly reduce the dosage of drugs and the side effects of drugs.
Second, for diseases requiring surgical treatment, the advantages of interventional therapy compared with surgical treatment are.
1, it does not require an incision to expose the lesion, generally only a few millimeters of skin incision, you can complete the treatment, epidermal damage is small, beautiful appearance.
2, most patients only need local anesthesia instead of general anesthesia, thus reducing the risk of anesthesia.
3.Small damage, fast recovery, satisfactory results, and little impact on the normal airways of the body.
4.For malignant tumors that are difficult to treat at present, interventional therapy can try to confine the drugs to the lesions and reduce the side effects on the body and other organs. Some tumors are comparable to surgical resection after interventional treatment.
Because of these many advantages, many interventional treatment methods have become one of the most important treatment methods for some diseases (such as: liver cancer, lung cancer, lumbar disc herniation, aneurysm, vascular malformation, uterine fibroids, etc.).
Commonly used techniques.
They are classified according to the path of the device into the lesion.
Endovascular interventions and non-endovascular interventions.
Endovascular interventions are defined as.
A 1-2mm thick puncture needle is used to enter the human vascular system by puncturing the superficial arteries and veins of the human body. With the knowledge of vascular anatomy that the doctor has acquired, the catheter is sent to the location of the lesion under the guidance of the angiography machine, and the contrast agent is injected through the catheter to show the vascular situation of the lesion and treat the lesion within the 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 interventions are defined as.
Simply speaking, it is a method of treating a lesion without entering the human vascular system, by directly puncturing through the skin to the lesion under the monitoring of imaging equipment, or entering the lesion through the human embodied channel. These include: percutaneous puncture tumor biopsy, intratumoral injection, disc puncture decompression, disc puncture ablation and so on.
In addition, there are also treatment methods that use puncture needles to directly puncture through the body surface to the artery supplying blood to the lesion. For the time being, they are classified by us as non-vascular interventions.
Classification.
Vascular/non-vascular interventions
Non-vascular interventions.
Various percutaneous biopsies, various non-vascular lumpectomies (including dilation and stenting of urinary tract, gastrointestinal tract, respiratory tract, biliary tract and other stenoses), local inactivation of solid tumors (percutaneous percutaneous intratumoral injection, radiofrequency ablation), drainage, fistula embolization by fistulotomy (stomach, bladder, etc.), tubal adhesion and recanalization, interventional treatment of herniated discs, vertebroplasty, plexus block for chronic pain, etc.
Vascular interventions.
Vascular diseases: including percutaneous endovenous angioplasty, vascular stenting, thrombolytic therapy, non-thrombotic ischemia, control of bleeding (acute and chronic trauma, postpartum, inflammation, varicose veins, etc.), vascular malformations and embolization of arteriovenous fistulas and hemangiomas, inferior vena cava filters, TIPSS, revascularization, various angiographic diagnostics, venous blood sampling diagnostics, etc.
Oncological diseases: including tumor blood supply embolization and drug perfusion, intra-arterial irradiation, prevention of radiation damage, chemotherapy, preoperative embolization of tumor vessels, vascular action drugs and alcohol perfusion.
Interventional Radiology
Introduction
Simply put, it is a minimally invasive endoluminal surgical treatment that uses high-tech equipment with television monitors to repair, expand, and unblock blood vessels in a patient’s body by making a small hole in one part of the body and then using a catheter to penetrate deep into the patient’s body. With clinical intervention as the main axis, the specialized discipline of interventional radiology has been formed.
Interventional radiology, also known as interventional therapeutics, is a rapidly developing discipline that integrates diagnostic radiology and clinical therapeutics in recent years. It is a clinical application discipline that is guided by diagnostic radiology equipment (digital subtraction X-ray machine, CT machine, MRI machine and conventional X-ray machine, etc.) to introduce specific devices into human lesions through tiny incisions for treatment. Interventional therapeutics is a non-surgical, minimally invasive procedure that can treat a variety of diseases. Interventional therapeutics has developed rapidly in recent decades and has become one of the three pillars of clinical practice, along with internal medicine and surgery.
Origin and development
The term “interventional radiology” was first coined by American radiologist Margulis, who was keenly aware that a new specialty was developing in the field of radiology and wrote a review entitled “Interventional radiology: a new specialty”, which was published in the internationally renowned academic journal AJR in March 1967. In this review, he defined interventional radiology as a diagnostic and therapeutic technique performed under fluoroscopic guidance. In this review, he defines interventional radiology as the practice of fluoroscopically guided diagnosis and treatment. However, the term “Interventional Radiology” became widely recognized by the academic community in 1976, when Wallace systematically described the concept of interventional radiology in the journal Cancer under the title “Interventional Radiology”. The term “Interventional Radiology” was officially recognized by the international academic community only after Wallace systematically described the concept of Interventional Radiology in the journal Cancer in 1976 and made a presentation at the first European Society of Radiology Interventional Radiology meeting held in Portugal in 1979.
The name “Interventional Radiology” has been translated by domestic scholars in various ways, such as “surgical radiology”, “interventional radiology “therapeutic radiology”, “invasive radiology”, etc., and also “catheterization”, but now generally willing to accept The name “interventional radiology” is generally accepted now. China’s interventional radiologists have also made a specific definition of this name. Interventional radiology is based on diagnostic imaging, under the guidance of medical imaging diagnostic equipment (DSA, US, CT, MRI, etc.), to make independent diagnosis and treatment of disease. It is minimally invasive intracavitary surgical treatment in terms of clinical treatment attributes.
Features.
Simple, safe, effective, minimally invasive and with few complications. To a certain extent, interventional therapy = surgery without incision. The advantages of interventional therapy over traditional surgical procedures are.
1. It does not require an incision and generally requires only local anesthesia rather than general anesthesia, thus reducing the risk.
2. Less damage, faster recovery, better results, less interference with the body, and protection of normal organs to the greatest extent.
For malignant tumors for which there is no cure, interventional therapy can limit the drugs to the lesion as much as possible, and reduce the side effects on the body and other organs.
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, lumbar disc herniation, aneurysm, vascular malformation, uterine fibroids, etc.), even replacing or eliminating the original surgical procedures.
Disadvantages.
Really expensive: The treatment cost charged for interventional therapy is quite high, which is generally difficult for families without health insurance or public health care to afford. The typical cost of treatment (excluding the cost of drugs) is over $1,000.