Peripheral vascular disease is due to plaques causing blockages in the arteries supplying the lower limbs (legs). This can lead to pain on walking (claudication), pain during lying down (rest pain) and non healing ulcers and gangrene of the feet. Interventional radiology plays an important role in treating these blockages (stenosis/occlusion), by angioplasty/stenting. Various state-of-the-art techniques such as balloon angioplasty, stenting, stent grafts, drug eluting ballooning and stenting, thrombolysis, laser, shockwave lithoplasty are used to clear these blockages and relieve the symptoms.

When an artery increases in size it can burst and cause life threatening bleeding, this condition is known as an aneurysm of the blood vessel. When this occurs in the main blood vessel, the aorta, it is known as aortic aneurysms. When the aorta, undergoes an internal tear, it is known as an aortic dissection.

Earlier these required surgical treatment which was associated with a moderate risk. Endovascular aortic stent grafting is now one of the main modalities for treating aortic aneurysms and dissections.

Here, stent grafts are used, which are stents with a surgical graft sutured on them. These devices exclude the aneurysm from the circualation, which prevents them from rupturing. Standard thoracic and abdominal aortic aneurysms, thoracoabdominal aortic aneurysms, arch aneurysms, dissections can now be treated with standard endovascular stent grafts, fenestrated aortic stent grafts. The advantages of these procedures are no or shortened anaesthesia time, quicker recovery and lower risk.

Varicose veins are twisted, enlarged veins of the superficial venous system, mainly of the legs. This common disorder can cause cosmetic concern, hyperpigmentation of the legs, non healing venous ulcers. The treatment for these can be medical (compression stockings, exercise) or endovenous; where we use laser, radiofrequency ablation or venaseal vein glue technique to close the varicosities and achieve ulcer healing. This treatment is highly effective and allows the patient to get back to normal activity within a day.

Clots can form anywhere in the vascular system, with the most common location being the deep veins of the lower limbs, which is known as deep vein thrombosis. These clots (thrombii) lead to venous swelling, ulcers and can lead to life threatning pulmonary thromboembolism. The treatment earlier was only medical, by giving anticoagulants, which was not satisfactory for large thrombii. Endovascular modalities such as IVC filters, suction thrombectomy (Penumbra, Angioget), thrombolysis, venous stenting for chronic deep venous thrombosis and May Thurner syndrome, play an important role in removing the thrombi from the deep veins of the legs and pulmonary arteries, hence relieving limb swelling, breathlessness.

Certain type of cancers can be treated by interventional radiology techniques. Most common are types of liver cancers, such as, hepatocellular carcinomas (HCC’s), colorectal liver metastasis, bile duct carcinoma (cholangiocarcinomas). These are treated by specialized techniques- tranarterial chemoembolization (TACE) , transarterial radioembolization (TARE), radiofrequency/microwave/cryoablation. These procedures are used for tumour control for inoperable tumours, enhance the quality of life for inoperable lesions, reduction in size of the tumour to facilitate surgery/cure.

Transarterial chemoembolization (TACE) is a procedure in which a low dose chemotherapy agent if delivered via the arterial route, targeted into the liver tumour, followed by reduction in the blood supply to the tumour by particulate embolization. Transarterial Radioembolisation (TARE) utilizes delivery of yttrium 90 (Beta radiating agent) directly into the tumour bed, via the arterial route to irradiate the tumour.

Ablative techniques such as radiofrequency, microwave and cryoablation are used to either burn (radiofrequency, microwave) or freeze (cryo) the tumour, so as to kill the tumour cells and try and achieve tumour control.

Procedures such as bile duct drainage and stenting for inoperable bile duct tumours, DJ stenting for inoperable urinary tract tumours, radiofrequency ablation for inoperable lung and kidney tumours are also done.

Certain conditions such as uterine fibroids, benign prostatic hypertrophy, varicoceles, arterial and venous malformations can be treated very effectively with an interventional technique known as embolization. Here the blood supply to these lesions are blocked superselectively, to reduce the size of the lesion, allievate symptoms caused by these conditions. The effectiveness and results of these procedures are excellent and well proven.

Although no medical treatment is 100% risk free, the risks of these interventional radiological procedures are far lower than the conventional form of treatment which used to be open surgery.

All of these procedures are performed with just a small puncture in the vessel, hence obviating the need of large incisions.

Most of these procedures require only 1-2 days of hospital stay as compared to surgical procedures which require 7-8 days.

Majority of the procedures are performed under local anesthesia as compared to open surgery which requires general anesthesia.

Risk, pain and recovery time are often significantly reduced.