Interventional Radiology

Interventional radiology is a relatively newly established subspecialty that includes minimally invasive surgical techniques performed without open surgery and the need for an operating room.

In the Interventional Radiology Department of Anadolu Health Center, diagnosis and treatment services are provided using imaging methods such as angiography, computed tomography, ultrasound, and magnetic resonance, through small skin incisions (percutaneous) or within blood vessels (endovascular) using special needles, wires, catheters (thin, flexible tubes), etc.

The department offers services utilizing the most advanced technology to meet all diagnostic and therapeutic requests of patients and physicians.

In interventional radiology services, quality control issues such as procedure and patient preparation, equipment, and personnel are planned with consideration for international guidelines (CIRSE, etc.). The ideal outcome (100% success, 0% complication) is targeted in all interventional procedures, adhering to the success and complication standards set by international guidelines.

Before each procedure, patients are evaluated by an interventional radiology physician, and if deemed necessary after examination, some imaging and laboratory tests are conducted. Specialized treatments that require skill, knowledge, and experience are performed by interventional radiologists who hold accredited international diplomas (European Board of Interventional Radiology, EBIR).

What interventional procedures are performed in the Interventional Radiology Department?

At Anadolu Health Center, all interventional radiological procedures can be performed for different systems and organs, as generally exemplified below.

Biopsies

Tissue sampling from different organs is evaluated in the laboratory for diagnosis using special needles under ultrasound (US), magnetic resonance (MR), or computed tomography (CT) guidance. These procedures are usually performed as outpatient with local anesthesia.

Tumor Marking

Tumor markings are performed for diagnostic purposes (to surgically remove the tissue) or for treatment purposes (prior to Cyberknife) using materials like metallic wires. This method is fundamentally similar to biopsy procedures.

Drainage Procedures / Catheters

Fluid collected in the body, such as urine, bile, abscesses, and cysts, can be drained using special needles under US/CT/fluoroscopy guidance. If necessary, catheters may be placed afterward, and sometimes chemicals may be administered into this area to prevent fluid accumulation.

Intravenous Catheters

In cases where sufficient venous access cannot be found or a larger venous access is needed for a longer duration, intravenous catheters can be used. For instance, catheters for chemotherapy and dialysis can be placed into the central venous system from veins in the neck or arm using special needles and wires under US/fluoroscopy guidance. Rarely, catheters may also be placed in arteries for similar purposes.

Vascular Treatments

Interventional radiology specialists can treat diseases of the arteries and veins related to all other organs in the body using angiographic methods similar to stent and balloon treatments applied to the coronary arteries of the heart. The aim here may not only be to open the vessel; sometimes, the goal may be to close the vessel causing bleeding or obstructing circulation.

Treatments for Vessel Narrowing and Blockages

Thrombosis, narrowing, and blockages in arteries or veins can cause complaints depending on the organ and type of vessel involved. For example, blockage of leg arteries in diabetic patients can lead to non-healing wounds in the feet, while narrowing of the renal artery can cause high blood pressure and impaired kidney function. Following angiography for diagnosis, angioplasty (balloon widening) and/or stenting (artificial vessel) can be performed for narrowed vessels, as done in coronary vessels. If there is a thrombus causing sudden blockage in arteries or veins, it can be removed with anticoagulant medications or mechanically. Because a thrombus in veins can travel to and block pulmonary vessels, posing a life-threatening risk, filters (umbrella-like devices) may be placed in the vessels.

Treatments for Hemorrhages

Embolization (blockage) treatments for acutely or chronically bleeding vessels due to trauma, tumors, aneurysms, gastrointestinal ulcers, etc., can be performed through angiographic means. In this potentially life-saving method, particles, metallic coils, or adhesive or occlusive liquid agents are used for this purpose.

Treatment of Abnormal Congenital Vascular Structures and Varicose Veins

Abnormal development of arteries, veins, or lymph vessels can lead to vascular malformations and varicose veins in various regions of the body or skin, which can cause significant functional organ loss and bleeding, not just cosmetic issues. These conditions can also be successfully treated in interventional radiology using sclerotherapy, liquid agents, intra-vascular lasers, and similar methods.

Oncological Treatments

Interventional radiology specialists work together with oncologists to improve cancer patients' diagnosis, combined treatments, management of complications, and ultimately enhance the quality of life for patients. Rapidly evolving interventional radiological treatments for liver tumors can be offered not only as a last resort but also as first or second-line therapies.

Tumor Ablation

Tumor ablation refers to treatments performed by heating (Radiofrequency, Microwave), freezing (Cryoablation), or injecting chemical substances like alcohol into tumors located at various sites in the body, accompanied by radiological imaging (US, CT, MR). This method is particularly effective and safe for liver tumors and can also be applied to the treatment of tumors in the lungs, kidneys, bone myoma, and more.

Chemoembolization

Chemoembolization is an angiographic method used in primary liver tumors (hepatocellular carcinoma) and metastatic tumors. After accessing the liver vessels with fine catheters, microspheres loaded with chemotherapy drugs are injected into the tumor bed, prolonging the contact time between the tumor and the chemotherapy agent, enhancing treatment efficacy, and reducing potential side effects of chemotherapy on healthy tissues. Additionally, these microspheres disrupt the vascular supply to the tumor tissue.

Radioembolization

Radioembolization is also an angiographic method used in primary liver tumors (hepatocellular carcinoma) and metastatic tumors. After entering the liver vessels with fine catheters, microspheres loaded with radioactive isotopes (Yttrium-90) are injected into the tumor bed. These microspheres emit beta rays that can penetrate tissue by approximately 2.5 mm, continuing their effects for several weeks. This leads to damage to the DNA structure of tumor cells due to radiation exposure, resulting in cell death. This method can also be used in cases of blockage in the liver portal vascular system. Its advantages over chemoembolization include better tolerance by patients, the ability to achieve effect with fewer sessions, and efficacy on larger lesions. Despite these advantages, it is a complex, two-stage, multidisciplinary treatment that can only be applied at accredited specialized centers.

Neuroradiological Treatments

Neuroradiological treatments involve interventions for diseases of the brain, spinal cord, and other parts of the nervous system. These conditions can lead not only to functional loss and paralysis but also to life-threatening serious complications. Brain hemorrhages due to aneurysms and strokes caused by thromboembolism in brain vessels are among the diseases treatable by interventional radiology.

Carotid Stenting

Narrowing and blockages in the carotid arteries, which supply blood to the brain, can cause temporary and permanent paralysis. Surgical or stent treatments can be applied for narrowing of the carotid arteries, but stenting is particularly preferred in patients with heart problems.

Brain Aneurysms

Aneurysms (balloon-like structures) in brain vessels pose a rupture risk depending on factors such as size, location, patient sex, and smoking. Ruptured brain aneurysms are among the most deadly and dramatic situations in medicine; unfortunately, one-third of patients die before reaching the hospital. It is essential to detect and treat high-risk aneurysms in advance, if possible. Treatments performed from within the vessel (e.g., metallic coils) for these aneurysms can be more effective and less risky than open surgery.

Acute Stroke

If strokes caused by thrombosis in brain vessels are treated within the first six hours through interventional radiology, encouraging results can be obtained. The fundamental basis of this treatment is the removal of the thrombus from within the blood vessel using angiographic methods. Its effectiveness has been proven in recent years, and it can significantly prevent potential strokes and functional loss when compared to other drug treatments.

Pain Treatments

As a symptom that diminishes quality of life, the treatment of chronic pain is also within the scope of interventional radiology. Pathologies in the nervous system, such as pressure or masses, and the resulting pain can be treated under imaging guidance. Similarly, bone tumors causing pain and vertebral compression fractures can be treated using methods such as radiofrequency and cement injection under imaging guidance.