Interventional Radiology
Core concepts
Know vascular access and embolisation principles: coils, particles, glue, and the role of the interventional radiologist in trauma, GI bleeding, and tumour therapy. Understand image-guided biopsy and drainage (Seldinger technique, catheter care). Learn vascular interventions: angioplasty/stenting, thrombolysis, and IVC filters. Know oncological interventions: TACE, ablation (RFA/MWA), and portal vein embolisation. Understand complications: bleeding, infection, non-target embolisation, and contrast reactions.
Traps
- Coil embolisation is permanent; particles may be temporary-know the indication.
- IVC filter is for patients who cannot be anticoagulated-not routine.
- TACE is for intermediate-stage HCC-know the staging.
- Non-target embolisation can cause ischaemia-know the anatomy.
- Do not forget radiation dose and contrast considerations.
Worked example / rule of thumb
A trauma patient with active extravasation on CT: angioembolisation is first-line if the patient is stable. Rule of thumb: stable patient + active bleed = embolise; unstable = surgery. For HCC, TACE for intermediate stage; ablation for small lesions.
Key points
- Embolisation agents: coils, particles, glue.
- IVC filter only when anticoagulation is contraindicated.
- TACE for intermediate-stage HCC; ablation for small lesions.
- Know non-target embolisation risks.
- Consider radiation and contrast safety.