What is interventional radiology?

  The term Interventional Radiology was first introduced in 1967 by Margulis, a renowned American radiologist. It is a marginal discipline that developed rapidly in the late 1970s. It is a series of techniques to diagnose and treat various diseases with the guidance of medical imaging equipment, based on diagnostic imaging and clinical diagnostics, combined with the principles of clinical therapeutics, using catheters, guidewires and other equipment. That is: under the guidance of imaging medicine (X-ray, ultrasound, CT, MRI), through the percutaneous puncture route or through the body’s original orifice, special catheters or devices are inserted into the lesion site for diagnostic imaging and treatment, or a series of diagnostic methods to obtain pathology, bacteriology, physiology and biochemistry, cytology and imaging data.  Interventional radiology was introduced to China in the early 1980s and involves the diagnosis and treatment of many systems of human diseases such as digestive, respiratory, orthopedic, urological, neurological, and cardiovascular diseases. Especially for conditions previously considered incurable or difficult to treat (various cancers, cardiovascular diseases), intervention has opened up new avenues of treatment that are simple, safe, less invasive, less comorbid, and more effective. It is a “non-surgical” method of diagnosing and treating various diseases by percutaneous puncture and cannulation under the guidance of imaging methods, such as drug infusion, vascular embolization or dilation and angioplasty. Because of its unique features in disease diagnosis and treatment, such as minimally invasive, reproducible, accurate positioning, high efficacy and fast results, low complication rate, and easy application of multiple techniques, it has rapidly established its important position in modern medical diagnosis and treatment. In November 1996, the State Science Committee, the Ministry of Health and the State Administration of Medicine formally adopted interventional medicine as the third major diagnosis and treatment system in modern clinical therapeutics, alongside with surgery and internal medicine.  Looking back at the development history of interventional radiology, interventional radiology is being recognized by the academic community and the majority of patients for its distinctive disciplinary characteristics of integrating diagnostic imaging and minimally invasive treatment under the guidance of medical imaging.  Interventional radiology has the following technical characteristics: 1, minimally invasive Often, diagnosis and treatment can be completed after only skin puncture, cannulation, physiological or surgical orifice cannulation.  2, repeatable In case of incomplete one-time treatment or recurrence of lesions, the treatment can be repeated several times via the same route.  3.Accurate positioning Since all operations are performed under the guidance of medical imaging equipment, the puncture and cannulation are accurate, and the diagnosis and treatment are less blind. For example, transcatheter drug cartridge system implantation increases the rate of catheter placement and reduces the rate of displacement compared to surgical methods.  4, high efficacy, block effect For bleeding lesions, vascular stenosis and other luminal stenosis, once the interventional technique is successful, the efficacy is immediately visible, such as immediate cessation of bleeding, immediate opening of the lumen, and immediate disappearance of the accompanying symptoms, which some people call “dramatic effect”. For some lesions that are difficult to treat medically or surgically, such as arteriovenous malformation and hepatocellular carcinoma, interventional treatment is more effective than traditional treatment.  5.Low complication rate Based on the above characteristics, the complication rate caused by interventional techniques is low, and serious complications that are fatal and disabling are extremely rare.  6.Simple application of multiple technologies For some lesions, multiple methods are needed simultaneously or in sequence to achieve good results. Multiple interventional techniques are convenient and less interfering with each other, with strong synergistic effect. For malignant obstruction of the biliary tract, percutaneous internal and external drainage of the hepatic biliary tract (PTCD) can be performed first, followed by internal stenting or endotracheal tube placement, and the tumor itself can be treated with internal irradiation or transarterial chemotherapy (chemotherapy for short) infusion. Stenosis can be treated by thrombolysis, balloon dilation, and endostent placement in conjunction with each other. Interventional treatment can be well coordinated with surgery, such as preoperative embolization of tumor can give a second chance to operate on huge tumor, which can reduce intraoperative bleeding, shorten operation time and improve tumor resection rate. For cases of bleeding, interventional techniques can first stop the bleeding. Then surgical resection of the primary lesion is performed. It can change the risky emergency surgery into safer elective surgery.  Clinical applications of interventional radiology: 1, vascular intervention: cardiovascular imaging and cardiac catheterization; drug infusion: intra-arterial infusion of chemotherapeutic drugs, thrombolytic drugs, hemostatic agents, etc.; vascular embolization: bleeding vessels, tumor vessels, arteriovenous malformations, arteriovenous fistulas, hemangiomas, splenic artery embolization, etc.; angioplasty: balloon dilation of heart valves and stenoses, internal stent placement and laser, spinoplasty, etc. 2, non-vascular interventions: percutaneous puncture biopsy, aspiration, drainage and treatment: such as percutaneous puncture biopsy and ablation of parenchymal organ lesions, percutaneous intervertebral disc chemical lysis or excision and nucleation, percutaneous puncture aspiration, drainage and drug injection treatment of abscesses and cysts, stone treatment, etc.; balloon dilation and endoprosthesis of ductal stenosis: such as tracheobronchial, esophageal, gastrointestinal, biliary, urethral, ureteral and Balloon dilation and endoprosthesis for anastomotic stenosis.