Interventional Radiology
Complete Procedure Guide

Evaluate peripheral arterial disease (PAD), claudication, critical limb ischemia, and acute limb ischemia. Determines location and severity of stenosis before intervention. Required for pre-operative vascular mapping.

Evaluate mesenteric ischemia, renovascular hypertension, GI hemorrhage, hepatic anatomy pre-TACE, and splenic/visceral vascular malformations. Essential pre-procedure mapping for embolization or bypass.

Restore blood flow in stenotic or occluded peripheral arteries. PTA inflates a balloon to open the vessel; a stent maintains patency if recoil or dissection occurs. Indicated for claudication, rest pain, and critical limb ischemia (CLI).

Treat renal artery stenosis causing resistant hypertension, ischemic nephropathy, or recurrent flash pulmonary edema. Stenting maintains patency after balloon angioplasty, especially at ostial atherosclerotic lesions.

CDT delivers thrombolytic agents (tPA, urokinase) directly into a clot through an infusion catheter. Used for acute/subacute DVT, pulmonary embolism, and arterial thrombosis. Reduces post-thrombotic syndrome risk compared to anticoagulation alone.

Arterial embolization occludes vessels feeding a hemorrhage. Used for GI bleeds (upper/lower), post-surgical hemorrhage, trauma, and hemorrhagic shock. Agents include coils, microspheres, gelfoam, n-BCA glue, or Onyx.

IVC filters trap pulmonary emboli in patients with DVT who cannot receive anticoagulation. Retrievable filters should be removed once the risk period resolves to avoid long-term complications (fracture, IVC perforation, migration).

Maintains hemodialysis access in patients with ESRD. Dysfunctional access (poor flow, elevated venous pressures, inadequate dialysis) is treated with angioplasty, thrombolysis, or stenting to restore patency and preserve long-term access.

TIPS creates an intrahepatic channel connecting the hepatic vein to the portal vein, reducing portal pressure. Manages refractory ascites, recurrent variceal hemorrhage, hepatic hydrothorax, and Budd-Chiari syndrome.

Obtain tissue samples for histopathological diagnosis, tumor staging, and molecular profiling. Avoids open surgical biopsy. Essential for cancer diagnosis, lymphoma workup, and unexplained organomegaly.

First-line minimally invasive treatment for abscesses, infected collections, bilomas, and hematomas. A pigtail catheter is placed under US or CT guidance for continuous drainage, avoiding open surgery and its associated risks.

Emergency drainage of obstructed kidney due to ureteral stones, strictures, or malignant compression. Catheter placed directly into the renal collecting system via a posterior flank approach to relieve obstruction and preserve renal function.

PTBD relieves biliary obstruction causing jaundice and cholangitis when ERCP fails or anatomy is altered. A catheter is inserted through the liver into the bile ducts to drain externally or internally (past obstruction into duodenum).

Stabilizes painful osteoporotic or pathologic vertebral compression fractures. Bone cement (PMMA) is injected to restore structural integrity and relieve pain. Kyphoplasty first inflates a balloon to restore vertebral height before cement injection.

Fluoroscopy or CT-guided delivery of corticosteroids into the epidural space to reduce inflammation around compressed nerve roots. Provides pain relief for radiculopathy, spinal stenosis, and herniated disc.

Thermal ablation destroys tumor cells using heat (RFA: 60–100°C; MWA: up to 150°C). Used for HCC, liver metastases, RCC, lung tumors, and bone lesions in non-surgical candidates. Creates coagulative necrosis extending 0.5–1 cm beyond tumor margin (ablative margin).

TACE delivers concentrated chemotherapy into tumor-feeding hepatic arteries while simultaneously embolizing those vessels (ischemic necrosis + direct chemo toxicity). DEB-TACE uses drug-eluting beads for sustained local drug release. Used as bridge-to-transplant, downstaging, or palliative therapy for HCC and liver-dominant metastases.

Long-term venous access for chemotherapy, TPN, antibiotics, blood draws, and IV medications. Ports are fully implanted (lowest infection risk, monthly flushing). PICCs for shorter-term access. Tunneled CVCs for patients requiring frequent access for months.

Endovascular coiling packs platinum microcoils through a microcatheter to occlude intracranial aneurysms, preventing rupture or re-bleeding after SAH. Preferred over surgical clipping for most locations due to lower morbidity. Flow diverters (Pipeline Stent) used for large/complex aneurysms.

Mechanical thrombectomy removes large vessel occlusions causing acute ischemic stroke. A stent retriever or aspiration catheter captures and removes the clot, restoring cerebral blood flow. Best outcomes within 6–24 hours of onset. Time-critical — "Time is Brain."

UFE is a minimally invasive alternative to hysterectomy for symptomatic uterine fibroids. Microspheres injected bilaterally into uterine arteries cut blood supply to fibroids, causing them to shrink. Treats heavy menstrual bleeding, pelvic pressure, and bulk symptoms while preserving the uterus.