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Interventional Radiology

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  • Interventional Radiology

Interventional Radiology (IR) is a subspecialty of Radiology where minimally-invasive image-guided procedures are used to diagnose and treat diseases in nearly every organ system. MakatiMed Interventional Radiologists are certified by the Philippine Society of Vascular and Interventional Radiology.

 

Expertise of an Interventional Radiologist include interpretation of diagnostic images (Computed Tomography (CT), Magnetic Resonance Imaging (MRI), radiographs, and ultrasound) and manipulation of special instruments (catheters, needles, and wires) in the body through imaging guidance. IR procedures use the least invasive techniques available to diagnose, treat, and improve the health outcomes among patients. The procedures usually have less risks, pain, recovery time, and can be done using local anesthesia.

 

For complex procedures, these may require sedation or general anesthesia, an intravenous contrast agent (used for medical imaging) may also be used, and patient admission may be warranted for medical clearance and observation.

 

Services Offered:

  • Embolization/Sclerotherapy Procedures (vascular tumors/malformations or visceral bleeding)

Embolization aims to treat, decrease the size, or control the growth of vascular tumors or malformations. Sclerotherapy involves the injection of medication directly into the tumor. These procedures are done under fluoroscopy and ultrasound guidance.

 

Embolization can also be done in cases of visceral bleeding such as bleeding ulcers.

 

  • Image-Guided Biopsy (bone, kidney, liver, lung, thyroid, and others)
A biopsy is a minimally-invasive procedure performed to obtain sample tissues from the body to determine if its is benign, malignant, or infectious. This can be done using a CT scan, ultrasound, or X-ray fluoroscopy. Special needles or core biopsy needles are used to draw out and cut tissues. Biopsy samples are interpreted with the help of Pathologists.

 

  • Image-Guided Drainage (chest and peritoneal drainages, cyst aspiration, paracentesis, sclerotherapy, and thoracentesis)

It is commonly performed to treat pleural effusions and ascites (fluid buildup in the chest and abdomen). This can be also used to treat abscesses using needles and wires, a small drainage catheter is placed within the chest or abdominal cavity. This procedure is intended to accelerate recovery in conjunction with antibiotic therapy.

 

Percutaneous drainage may also be done for other fluid buildups in the body including large liver and kidney cysts or post-surgical seromas (pockets of fluid).

 

  • Image-Guided Kidney Procedures (nephrostomy)
Percutaneous nephrostomy is a procedure where a small, flexible, plastic tube is placed through the skin into the collecting system of the kidney to drain an obstructed urinary system, usually due to infection or inflammation, stones, or tumors.

 

  • Image-Guided Liver and Biliary Procedures (biliary drainage, biliary stone extraction, biliary stricture dilatation, and cholecystostomy)
Percutaneous transhepatic biliary drainage is a procedure where a small, flexible, plastic tube is placed through the skin into the liver or gallbladder to drain an obstructed bile duct system. If a bile duct or gallbladder is blocked, the bile (fluid that helps in digestion) cannot be drained normally and backs up in the liver. The tube can also be maneuvered past the obstruction site into the bowel.

 

  • Image-Guided Pain Management Procedures (celiac axis block, epidural steroid injections, facet and hip joint injections, radiofrequency (RF) rhizotomy or neurotomy)

Spinal injection procedures can be performed accurately through fluoroscopic or CT guidance. Medications (usually an anesthetic and steroid) are injected along the nerve root or joint space to help control pain.

 

Radiographic guidance for selective nerve blocks and epidural injections allows accurate needle placement and reduces the procedure time.

 

Celiac plexus block involves the injection of a medication (usually a sclerosing agent and anesthetic) to help relieve abdominal pain, commonly due to cancer or chronic pancreatitis.

 

Radiofrequency (RF) rhizotomy or neurotomy is a minimally-invasive procedure designed to decrease and/or eliminate pain secondary to degenerative facet joints of the spine. The procedure involves the use of special heat-generating needles to destroy the nerves that supply the facet joints.

 

  • Inferior Vena Cava (IVC) Filter Placement
The filter is a small device that is placed within the inferior vena cava, a large vein in the abdomen that returns blood from the lower half of the body to heart. It works by reducing the risk of pulmonary embolism by trapping large clots and preventing them from reaching the heart and the lungs. It is prescribed to patients who do not respond to or cannot be given blood thinners.

 

  • Interventional Oncology (embolization procedures, radioembolization or selective internal radiation therapy, radiofrequency/microwave ablation)

Tumor ablation is a minimally-invasive procedure that uses special needles to treat solid cancers. These needles include radiofrequency needles and microwave antennae, used to burn the tumors without surgery, under CT or ultrasound guidance.

 

Tumor embolization involves the use of X-rays or fluoroscopy to guide needles and wires into the arteries that supply blood to a tumor. This is most commonly done for liver tumors. Several materials can be used to treat a tumor including beads, coils, and Lipiodol (medical oil-based embolic agent). Liver chemoembolization usually involves injection of a chemotherapeutic drug together with the embolic agent. Embolization can also be done to control bleeding tumors or prior to a surgery to decrease blood loss.

 

Radioembolization or Selective Internal Radiation Therapy (SIRT) uses the same technique as tumor embolization but special radioactive beads are injected into the liver tumor.

 

  • Thrombectomy and Thrombolysis
An endovascular thrombectomy or thrombolysis is the removal of a blood clot (thrombus) under image guidance. It is most commonly performed for an arterial embolism, including mesenteric ischemia, pulmonary embolism, or stroke. Techniques to remove include the use of a vacuum to suck the blood clot out, a mechanical equipment to break it up, or the injection of a thrombolytic medicine.

 

  • Venous Access Procedures (implanted ports, peripherally-inserted central catheter lines)
Central venous access involves the placement of long, thin, plastic tubes into a large vein in the arm, chest, or neck with its tip in the largest vein near the heart. The catheter can be planted safely for weeks, months, sometimes for more than a year. It is commonly used for blood sampling, diagnostic procedures with contrast infusion, and infusion of drugs and blood products, temporary dialysis and feeding.

 

 

Chairperson of the Department of Radiology:
Jackson U. Dy, MD

Section Head:
Alvin Constantine T. Tin, MD

Overview

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  • Ground Flr., Tower 1
  • +632 8888 8999
    locals 1029 & 2070
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  • X-Ray
  • TomoTherapy Radiation
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