Strides in IR

Dr Vikram Shende.
MBBS(GOLD MEDALIST), MD-RADIODIAGNOSIS, FVIR-
KEMH MUMBAI, FOIR-HCG BENGALURU, FRCR-2A
ASSISTANT PROFESSOR & INTERVENTIONAL RADIOLOGIST
DEPT OF RADIOLOGY.
MGM MEDICAL COLLEGE, KAMOTHE.
 Beginning
• It all started a year back with a young dynamic
Interventional Radiologist Dr.Sushil Patil joining
our Institute and starting the Interventional
Radiology.
• Starting with EVLA and Image guided biopsies
and now within a short span of one year the
department and grown leaps and bounds and
now can boast 2 Dedicated Interventional
Radiologists making significant changes in patient
management.
• We started our journey with EVLA with the
guidance of respected Dr.Kalyanshetty Sir who
encouraged us, referred varicose veins
patients to us and also made the Laser
machine available to us.
 Interventional radiology
 Minimally invasive therapy - No incision / sutures

 Image-guided.

X-ray, CT, USG, MRI- to guide

small needles or thin tubes

precisely to organ of interest.

 Scope of IR
• Peripheral vascular interventions.
• MSK
• Gynaec
• GI
• Neuro
• Urological
• Respiratory
• Interventions in Trauma
EVLT- varicose veins
 Vascular Malformation
• 4yrs boy, gradually increasing
cheek swelling

Post 1 session

Sclerotherapy
 Coeliac block
• Ca stomach with adenopathy. Severe abd Pain.
 Image guided Biopsies

• OMFS pt
Paravertebral lesion biopsy
Coaxial technique
 Hepatobiliary system
Biliary drainage (PTBD)- Ca Gallbladder
 Peripheral Vascular Disease.
• A 60 year old male.
• Severe claudication pain.
• Post prandial abdominal pain.

• USG doppler-
Monophasic reduced flow in femoral artery
downwards- Likely secondary to iliac occlusion.
 IMAGING
CT ANGIOGRAM

• Complete occlusion of Left common iliac, SMA &

severe stenosis of Inf Mesenteric artery.
 ANGIOGRAPHY

Complete occlusion CIA negotiated

Inferior mesenteric and left common iliac stenting.
 Urological procedures
Percutaneous Nephrostomy PCN
Bilateral HDN.
Diversion PCN
 Renal angioembolisation
• Post traumatic hematuria.
• Persistent at 1 month.
• Multiple transfusions
 Gynaecological procedures
Emergency bleeding
• 34yrs/F
• Referred for Uterine artery embolisation i/v/o Postpartum
haemorrhage.
• Pt had underwent elective CS, found to have adherent
placenta, underwent emergency caeserian hysterectomy for
persistent bleeding.
• Pt continue to bleed through suture sites & PV.
• Inotropic support +
Embolisation in PPH
 Neuro Cases
IC bleed
• 23y/F, Mrs. AP

• Referred to MGM i/v/o

acute onset altered
mental state &
hemiplegia.

• No past significant history.

Pre
Post
Post op course
• Power regained slowly
& Could walk without
support.

• Discharged on Day 8
with no neurodeficiet.
 Team effort.!!!
Hospital administration.

Department of Medicine.

Department of Radiology.

Department of Neurology & Neurosurgery.

Department of PSM & MJPJAY section.

 Case 2 – ACOM Anuerysm
• 70yrs/F Mrs MP.
• Presented with sudden onset severe
headache.
• K/c/o HTN on medications.
• CT plain - Extensive SAH.
• CT Angio- Suspicious outpouching in
A1/A2 ACA territory
• Referred for DSA & SOS further
intervention
DSA
 Advantages

Better outcomes with Minimum risk.

Less painful & morbid.

Early recovery.
 Alternative Funding Options
Issuing cost certificates with Help of Social Welfare Officer to arrange funds from

1. Chief Minister Fund

2. Prime Minister Fund
3. NGO’s like : Siddhi Vinayak Trust
4. Being Human Trust
5. Shankar Shetty Trust.
6. TATA Trust.
 LIMITATIONS
• No dedicated IR Cath lab
• No dedicated IR staff.
• No dedicated IR OPD
• No dedicated allotted beds under IR for patient
admission.
• Non availability of IR materials in pharmacy.
• Non availability of pressure injector in Cath Lab.
• Non availability of Cath lab and staffs for
emergency cases.
 SUPPORT FROM RADIOLOGY
• Dynamic, supportive and enthusiastic HOD
Dr.Priti Kapoor Ma’am pushing IR towards new
and better strides.
• Dedicated round the clock 2 Interventional
Radiologists.
• Renowned and Senior Interventional Radiologist
always available for guidance like Dr.Abhijit Soni,
Dr.Vivek Ukirde sir.
• Energetic and enthusiastic residents, keen to
learn IR.
 Future plans
• Dedicated IR OPD.

• Stroke unit & emergency neuro services.

• Outreach programme- Varicose & diabetic foot

camp.

• Hybrid OT’s.

• Start DM in Interventional Radiology Courses.

Everyone needs a helping hand from
time to time. Let’s not miss our
opportunity to lend our help for the
best of the patient.
• And As our Hon’ble Medical Director Says
“THE BUCK SHOULD STOP HERE”

• Thank you..!!!