Interventional Radiology in the Older Patient

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Interventional Radiology in the Older Patient

• Dr Stuart Kerr
• Consultant Radiologist
• Mid Yorkshire NHS Trust

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Dr Charles T Dotter, 1964
Dr Alfred Kratochwil, 1969
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Subspecialisation

• coronary ? Cardiology
• neurological
• peripheral vascular
• non-vascular

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Vascular Intervention

• diagnostic angiogram
• angioplasty /- stent for arterial stenosis
• stent graft for aortic aneurysm/dissection
• embolisation
• IVC filter
• SVC stent
• Hickman / PICC lines

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GI haemorrhage

• Endoscopy first
• If negative, diagnostic CT angiogram
• - DONT DELAY!
• Low threshold for speaking to Interventional
  Radiologist

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PICC line
chemotherapy antibiotics total parenteral
nutrition
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Non-vascular Intervention
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Ultrasound v CT

• real-time visualisation
• portable
• quick
• no radiation
• frees up CT scanner

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US-guided biopsy
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Cholecystostomy

• indications
• - severe acute cholecystitis
• - not improving after 48 hours
• - gall bladder perforation
• tubogram at 6 weeks
• ? percutaneous biliary stent

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Percutaneous Transhepatic Cholangiography
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Oesophageal stent
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Pyloroduodenal stent
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Colonic stent
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Radiologically Inserted Gastrostomy (RIG)
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Nephrostomy
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Tumour ablation

• radiofrequency (RFA)
• cryotherapy
• microwave
• chemical
• transarterial embolisation / chemoembolisation
  (TACE)

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• 
  
• 
  J Hepatol
  201257794

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When things go wrong..
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Consent
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Thank you