Interventional and Vascular Radiology
Core concepts
Know the indications and techniques for image-guided procedures: biopsy, drainage, and vascular access. Understand the principles of angiography: Seldinger technique, catheter selection, and embolization materials. Master the management of bleeding (embolization), tumor ablation (radiofrequency, microwave), and venous access (central lines, ports). Recognize the complications of interventions: hemorrhage, infection, and contrast reactions. Understand the role of thrombolysis and thrombectomy in acute limb ischemia and stroke. Know the principles of radiation dose reduction during fluoroscopy.
Traps
Do not choose an intervention without considering coagulation status and contraindications. Beware attributing post-procedure fever to infection when it may be post-embolization syndrome. Recognize that contrast nephropathy risk is higher in renal insufficiency.
Rule of thumb
For acute arterial bleeding, embolization is first-line when endoscopic or surgical options are unavailable or fail.
Worked example
A trauma patient with a pelvic fracture and hemodynamic instability: angioembolization of the internal iliac branches can control hemorrhage when surgery is not feasible.