EBIR key terms

Method of gaining vascular access by puncturing a vessel with a needle, passing a guidewire through the needle, removing the needle, and then advancing a catheter over the wire.

Access kit using a thin 21-gauge needle and a short fine guidewire to enter a vessel before upsizing with a dilator and sheath, reducing bleeding risk in difficult or small vessels.

Percutaneous entry into the common femoral artery or vein, ideally at the mid-femoral head level below the inguinal ligament, the default route for most vascular interventions.

Life-threatening bleeding into the retroperitoneum, typically caused by puncture of the common femoral artery above the inguinal ligament, presenting with back pain, hypotension and falling haemoglobin.

Implantable or suture-based system deployed at the arteriotomy after catheter removal to achieve rapid haemostasis, allowing earlier ambulation, but unsuitable for punctures above the femoral bifurcation or in heavily calcified arteries.

Flexible wire used to navigate vessels and provide a rail for catheter advancement; its diameter, tip shape, stiffness and coating determine its behaviour in tortuous or stenotic anatomy.

Lubricious polymer layer on wires and catheters that becomes slippery when wet, improving navigation through tortuous or stenotic vessels but increasing the risk of the device slipping out of position.

Pre-shaped selective catheter with a curved distal hook used to engage branch vessels arising at acute angles, such as the renal, coeliac or visceral arteries, during diagnostic angiography and embolisation.

Imaging technique in which a pre-contrast mask image is subtracted from contrast-enhanced frames, removing bone and background so that opacified vessels are displayed with high contrast.

Use of carbon dioxide gas as a negative contrast agent for angiography, avoiding iodinated contrast and nephrotoxicity; it is buoyant, so patient positioning and injection technique must be adapted.

Acute deterioration in renal function occurring within days of iodinated contrast administration, prevented by adequate hydration, minimising contrast volume and identifying at-risk patients before the procedure.

Widening of a narrowed artery by inflating a balloon catheter across the lesion, which fractures plaque and stretches the vessel wall, restoring flow without leaving a permanent implant.

Balloon coated with an antiproliferative drug such as paclitaxel that is transferred to the vessel wall during inflation, reducing neointimal hyperplasia and restenosis after angioplasty.

Metallic or polymer mesh tube deployed across a stenosis or occlusion to maintain luminal patency by radial force, either balloon-expandable for precision or self-expanding for flexibility.

Renarrowing within a previously stented segment caused by neointimal tissue growth or stent underexpansion, treated with drug-eluting balloons, additional stenting or debulking techniques.

Deliberate occlusion of a vessel by delivering coils, particles, glue or plugs through a catheter, used to stop haemorrhage, treat aneurysms, devascularise tumours or shrink vascular malformations.

Delivery of metallic coils into a vessel or aneurysm sac so that the resulting thrombus and coil mass occlude flow; coil size and packing density determine stability of the occlusion.

Locoregional liver cancer treatment combining intra-arterial chemotherapy with embolic particles, exploiting the predominant arterial supply of hepatocellular carcinoma to deliver drug while inducing ischaemia.

Delivery of yttrium-90-loaded microspheres into hepatic arteries supplying tumour, providing local beta irradiation; requires pre-treatment mapping angiography and lung shunt assessment.

Prolonged infusion of a fibrinolytic agent directly into a thrombosed vessel or graft through a multi-side-hole catheter, dissolving clot with lower systemic drug exposure than intravenous therapy.

Combined technique that macerates thrombus with a mechanical device while dispersing lytic drug into the clot, shortening treatment time and reducing the lytic dose required.

Endovascular prosthesis consisting of a fabric tube supported by metallic struts, deployed inside the aorta to exclude an aneurysm from the circulation and reduce rupture risk.

Persistent blood flow outside the stent-graft but within the aneurysm sac after endovascular repair, classified by source; some types require reintervention because sac pressure remains elevated.

Creation of a channel through liver parenchyma between hepatic vein and portal vein, held open by a covered stent, to decompress portal hypertension and treat variceal bleeding or refractory ascites.

Neuropsychiatric dysfunction caused by shunting of portal blood past the liver, a major complication of portosystemic shunts, managed by lactulose, rifaximin and shunt reduction if severe.

Raised pressure in the portal venous system, usually from cirrhosis, leading to varices, ascites and splenomegaly; measured as the hepatic venous pressure gradient at venography.

Imaging of the biliary tree by puncturing a peripheral intrahepatic duct under fluoroscopic or ultrasound guidance and injecting contrast, often the first step to biliary drainage.

Placement of a catheter across an obstructed bile duct, either percutaneously or endoscopically, to relieve jaundice, cholangitis or pruritus and allow decompression before definitive treatment.

Insertion of a plastic or metal stent across a malignant or benign biliary stricture to restore bile flow, usually after track dilatation, with metal stents reserved for palliation or selected benign disease.

Percutaneous placement of a drainage catheter into the renal collecting system to relieve obstruction or provide access for stone surgery, performed under ultrasound and fluoroscopic guidance.

Double-pigtail tube placed in the ureter to maintain drainage from kidney to bladder, used for obstruction, after stone treatment or to protect the ureter during surgery.

Removal of renal stones through a percutaneous tract dilated into the collecting system, using nephroscopy and lithotripsy; the standard treatment for large or complex stones.

Thermal tumour destruction using alternating current delivered through an electrode, generating frictional heat that coagulates tissue within a defined zone, commonly applied to liver and lung lesions.

Thermal ablation using electromagnetic waves to agitate water molecules, producing larger and faster heating zones than radiofrequency, less affected by tissue perfusion and charring.

Non-thermal ablation that applies short high-voltage pulses to disrupt cell membranes, sparing collagen and large vessels, useful for tumours adjacent to critical structures.

Tumour destruction by repeated freeze-thaw cycles using cryoprobes, causing ice-ball formation, cellular dehydration and vascular injury; the ice ball is visible on CT for real-time monitoring.

Percutaneous injection of bone cement into a fractured vertebral body to stabilise it and relieve pain, performed under fluoroscopy with careful control of cement viscosity and volume.

Vertebral augmentation in which a balloon is inflated inside the fractured body to restore height and create a cavity before cement injection, aiming to reduce kyphosis and cement leakage.

Escape of bone cement beyond the vertebral body into veins, disc space or spinal canal during augmentation, a recognised complication that can cause pulmonary embolism or cord compression.

Measure of total radiation energy delivered to a patient during a fluoroscopic procedure, used to estimate stochastic risk and to trigger follow-up for potential skin injury.

Principle of keeping radiation exposure as low as reasonably achievable by minimising fluoroscopy time, using pulsed low-dose settings, collimation and last-image hold rather than live screening.

Cumulative duration of X-ray exposure during a procedure, a simple quality indicator that correlates with operator experience and complexity but not directly with patient skin dose.

Documented discussion of a procedure's purpose, alternatives, material risks and expected recovery, obtained before intervention and tailored to the individual patient's clinical situation.

Team pause immediately before starting a procedure to confirm patient identity, procedure, side, allergies, anticoagulation status and equipment availability, reducing wrong-site and medication errors.