Interventional radiology
02 Haziran 2023

Diagnostic and Therapeutic Procedures Applied in the Department of Interventional Radiology
I: Vascular/Intravascular:
a: Peripheral Artery and Vein Interventions
b: Brain and Spinal Cord Vascular Interventions (Interventional Neuroradiology)
c: Minimally Invasive Cancer Interventions (Interventional Oncology)
II: Non-vascular: Treatments in Body Cavities
                                                     I. Vascular (vascular) Interventional Methods

       a. Peripheral Artery and Vein Interventions

Diagnostic Angiography (Arteriography/Venography)
With the introduction of iodinated contrast material into the arteries or veins in the body, or carbon dioxide in those with kidney disease.
vascular diseases such as stenosis, occlusion, thrombosis (clotting) and aneurysm (enlargement / bubble) or arteriovenous malformation
It is an interventional method used in the diagnosis of vascular masses.

Lymphangiography / Lymphatic Embolization
Special drugs for lymphatic channels or lymph nodes for the diagnosis and treatment of lymphatic leaks, which usually develop after certain operations.
It is a method of imaging the lymphatic system and closing lymphatic leaks by giving Balloon Angioplasty, Artery and Vein Stenting
Balloon angioplasty is the removal of stenoses and blockages in all other vessels in the body, except the heart vessels, with the help of balloons with or without medication.
It is a method of expanding or opening. Stenting is tubular metallic medical equipment that can be inserted into the vein to reduce stenosis and occlusions.
is a method of elimination.

Atherectomy (Vessel Trimming), Thrombectomy (Cot Removal) and Thrombolysis (Cloth Dissolution)
Shaving, dissolving or expelling the clots formed in the arteries and veins with the help of drugs or medical devices
removal operations.

Treatments for Diabetic Foot Wounds and Buerger's Disease
One of the underlying causes of non-healing wounds in patients with diabetic foot is the insufficiency of blood flow due to vascular stenosis and occlusion.
In diabetic foot patients, the vessels must be evaluated and, if present, stenosis and obstruction should be eliminated. If such risks are not addressed
Diabetic foot is progressive and can lead to organ loss. Buerger's disease, which is a peripheral arterial disease caused by smoking.
vascular stenosis and occlusions that cause shortening in walking distance due to leg pain (claudication) that develops when the patient walks.
should be similarly resolved. Buerger's disease is a disease that is observed in smoking men, and smoking should be stopped in its treatment.
is an inflammatory vascular disease. The success rate of endovascular (balloon) therapy is low in active smokers.
If vascular stenosis and occlusion are detected in interventional radiology, balloon angioplasty and stent placement can be performed for them.
In the treatment of peripheral arteries (arteries), balloon angioplasty and stent are placed in the leg arteries (iliac, femoral… arteries) starting from the aorta.
Stenosis and occlusions in the calf arteries can also be treated with balloon and stent technologies today. Able to reach stenosis at ankle level
Thanks to the new technology balloons, flow can be provided in the foot veins (arteries-arteries) and amputation can be prevented.
Thrombus and atheroma plaques that cause vascular occlusions can also be removed with the new technology product clot-removing-thrombectomy and plaque-removing-atherectomy systems.
can be cleaned.

Treatment of Dialysis Fistula Stenosis or Occlusion
Treatment of stenosis or occlusions that prevent the effective functioning of existing dialysis fistulas by interventional radiology with angioplasty methods.
can be done. The continuity of the existing fistula is very important because there are a certain number of vessels in the body to form a fistula. Obstruction symptoms begin
Balloon treatments performed as soon as possible prolongs the life of the fistula.

Embolization (Occupation)
It is the process of temporarily or permanently blocking the vessels that feed a disease-causing area, organ or mass in the body. For example, gastrointestinal
System (digestive system) bleeding and hemoptysis (cough and sputum with blood) in order to stop the bleeding, the relevant vein should be selectively selected.
occlusion of the vessel causing internal bleeding or intramuscular bleeding after a trauma or disease, and reduction of vascular masses,
To facilitate the disappearance or surgery, the occlusion of the feeding vessels may be given. Adenomyosis Embolization
Adenomyosis, which is caused by the growth of the endometrium layer, which is the innermost layer of the uterus, towards the myometrium layer, is painful and/or prolonged.
It is a condition that causes menstrual period. Treatment of adenomyosis by embolization of the arteries supplying the uterus with interventional radiological methods.
Complaints can be improved by preventing their feeding.

Fibroid Embolization
Embolization (occlusion) of the vessels, some of which are fed by fibroids, which are quite common in women and cause complaints such as pain and bleeding.
It can be reduced without surgery and complaints can be reduced.

Prostate Gland Embolization
In this method, prostate gland enlargement, prostate gland shrinkage after embolization (occlusion) procedure for the arteries feeding the prostate gland.
and improvement in the patient's complaints can be achieved. The complication rate is negligible. It has no negative effect on sexual functions.

Pelvic Congestion and Varicocele Treatment
In case of enlargement of the veins of the reproductive organs, which may cause pain or reproductive disorders, these veins
Complaints can be improved as a result of the embolization (occlusion) procedure performed by entering

Hemorrhoids (Hemorrhoids) Treatment (Hemorrhoidal Artery Embolization)
Hemorrhoidal artery embolization (occlusion of the vessels that cause hemorrhoids by means of the artery) method, which eliminates the need for surgery, is short-lived,
It is a comfortable treatment method that does not require hospitalization.

Embolization in Joint Pain
-Moderate Knee Pain Due to Knee Calcification (Geniculate Artery Embolization)
-Golfer Elbow and Tennis Elbow (Medial and Lateral Epicondylitis)
-Frozen Shoulder
It can be applied in painful joint diseases such as painful joint diseases that last longer than three months and do not respond to painkillers. More than two years with the right patient selection
is effective for a long time. (This method is not applied in spinal diseases.)

Treatment of Vascular Malformations (Vascular Anomalies) and Hemangiomas
Vascular clumps and benign tumors seen in the organs or tissues of the body, through a thin needle through the vein and/or the skin, at once or
It can be treated in sessions.

Vena Cava Filter
In order to prevent life-threatening pulmonary embolism (clot in the lung) after deep vein thrombosis (vein coagulation) in the legs,
It is the process of placing a filter that allows the passage of blood into the vena cava, which is the main vein of the body, but filters the clot particles.

Venous Sampling (Adrenal and Inferior Petrosal Sinus)
It replaces hormone-secreting tumors that cannot be determined by medical imaging methods in hormone-secreting organs such as the pituitary and adrenal glands.
It is the process of taking blood samples from the veins where the hormone is secreted in order to determine Inferior petrosal sinus and adrenal vein sampling
example of this method.

Varicose Veins Treatment
Treatment of varicose veins caused by backward leakage (insufficiency) in the superficial veins of the legs is also intravenous radiofrequency ablation.
It can be done with sclerotherapy methods and pain and visual disturbances in the legs can be treated.

TIPS (Transjugular Intrahepatic Portosystemic Shunt)
In liver cirrhosis, due to fibrosis in the liver, it carries blood from the digestive system to the liver and is called the portal vein.
increased resistance in the veins (Portal Hypertension) occurs. In order to reduce or eliminate the bleeding caused by varicose veins around the stomach and esophagus as a result of portal hypertension, and the water (acid) accumulated in the abdomen, in order to connect the portal vein in the liver and the hepatic vein, which takes the blood from the liver to the heart via the vena cava, by placing a stent, the resistance in the portal vein reduction

b. Neuroradiological Interventions (Interventional Neuroradiology)

Diagnostic Angiography (Arteriography/Venography)
Stenosis, occlusion, thrombosis (coagulation) and
It is used in the diagnosis of vascular diseases such as aneurysm (enlargement/bubble) or vascular-rich masses such as arteriovenous malformation.
interventional method.

Carotid Artery Stenting (Stenting of Carotid Artery Stenosis)
The jugular vein, which is the main vein that feeds our brain, is a vein that is very affected by narrowing and blockages due to atherosclerosis. narrowing of the jugular vein
- Temporary paralysis, loss of vision, due to insufficient blood supply to the brain in case of occlusion or due to particles that break off from the stenosis and go to the brain,
inability to speak, very serious permanent paralysis and even loss of life may occur. If the narrowing is mild, that is, if there is less than 70% narrowing in the vessel, the risk is low and the drug
treatment is sufficient. If the narrowing of the neck artery is more than 70%, the probability of a clot to the brain is higher and is usually used to correct the stenosis or
must be eliminated. In patients who are suitable for intravenous treatment, stenosis is shown during angiography and then a special filter is placed and the procedure is performed.
During the operation, the possibility of leakage to the brain is reduced, and then the stenosis is opened with safe stent and balloon applications. The patient immediately after the procedure
returns to bed and is discharged after one night hospital stay.

Stroke (Paralysis) Treatment
It is a method of removing clots that form in the brain vessels and cause stroke with aspiration or clot-removing stents.
Paralysis with symptoms such as speech disorder, weakness in arms and legs, slippage in the mouth, loss of vision requires emergency treatment. In the first 6-8 hours
In patients who can be intervened and blood flow to the brain tissue can be restored, paralysis can be completely or slightly recovered.

Brain Aneurysms (Bubble) Treatment
Anesthesia is caused by bubbles that form in the brain vessels, which can cause subarachnoid hemorrhage (SAH) and can be fatal when they cause hemorrhage.
It is the process of treatment with angiography method.
Interventional neuroradiologists perform this procedure in the angiography unit while the patient is under general anesthesia. In the groin with a needle without making a surgical incision
enters the artery. Various catheters, microcatheters and wires are used to enter the aneurysm. Aneurysm with platinum coils (coil) placed through the microcatheter
clogged and prevents blood from entering. In some cases, to assist the coiling process and protect normal vessels adjacent to the aneurysm.
A stent or balloon can also be used. As a result, thanks to the embolization procedure, brain aneurysms are treated without the need for open surgery and bleeding
risk is avoided.

Brain and Spinal AVM (Vascular Ball)-AVF (Abnormal Connections Between Arteries and Veins) Embolization
In normal condition, arteries and veins connect with each other with very thin capillaries. Capillaries to all tissues in the body
and nutrient vessels that carry blood to the cells. Arteriovenous malformation (AVM) is mostly congenital or occurs after birth.
It is the direct relationship between the ascending artery and the veins without normal capillaries and forming a ball. Usually with age
these vascular bundles tend to enlarge. Seizure due to malnutrition in the tissue in AVM because there are no feeding capillaries
Life-threatening conditions such as signs of bleeding or rupture of weakened walled vessels in the AVM causing cerebral hemorrhage may occur.
may come out. Intravenous treatment performed by interventional radiology and special embolizing (occlusive) drug into the vascular ball with soft and thin microcatheters
is injected. In this way, with the closure of the vascular balls, they shrink to facilitate surgery or radiation treatments to be performed afterwards.
can be provided.

Middle Meningeal Artery Embolization
In frequently recurring subdural hemorrhages, MMA (middle meningeal artery) can be embolized to prevent recurrences.
Retinoblastoma Treatment
It is the direct injection of the chemotherapeutic agent into the target through the ophthalmic artery in pediatric patients with retinoblastoma.
Epidural Blood Patch
In severe headaches caused by tears in the spinal canal membrane, the tear is closed by giving the patient's own blood outside the canal.
It is a method that is performed by injecting bone cement into the damaged spine in compression fractures of the spine, which relieves pain and provides stabilization.

c.Oncological Interventions (Minimally Invasive Cancer Treatments / Interventional Oncology)

Percutaneous Tumor Treatments
-RF (Radiofrequency) Ablation
-Microwave Ablation
-Cryoablation (Freezing)

Benign, malignant or metastatic tumors of a certain number and size that occur mainly in organs such as liver, kidney, thyroid, breast and bone.
These are the methods of burning (radiofrequency/microwave ablation) or freezing (cryoablation) with the help of needles sent through a small incision from the skin.
Examples of diseases treated with this method are malignant tumors in the liver, lung and kidney, and pain, such as osteoid osteoma in the bone.
benign tumors that cause

Transarterial Chemoembolization (TAKE) and Radioembolization (TARE)
It is used in the treatment and control of liver metastases (spread) of liver and biliary tract tumors and cancers of other organs and systems.
By entering the arteries feeding the tumor with these methods, chemotherapy drugs (TAKE) or particles containing radiation (TARE) are transferred to the tumor bed.
is given. In this way, it is possible to increase the treatment effect and reduce the side effects.

II.Non-Vascular (Non-vascular) Interventional Methods

Imaging of many tissues and organs in the body such as lungs, liver, pancreas, kidney, thyroid gland, breast, soft tissues, bone and lymph nodes
Biopsy under the guidance of methods helps to diagnose diseases and most procedures are painless, hospitalized with local anesthesia.
It ensures that it can be done in a short time and with low risk by minimizing vascular injuries and without the need to go to bed. TG with biopsy,
Thyroid and parathyroid gland diseases can be detected more successfully with PTH, Calcitonin wash out techniques.

Draining the fluid or inflammation (abscess) caused by various infections or surgeries in the body cavities and organs through the catheter,
It is a method used to stop the spread and progression of the infection and to help antibiotic treatment be more effective.

Three-dimensional location of suspected masses or regions in tissues or organs in the body, especially breast and lymph nodes, in surgeries.
wire, radiolabeled material, or microwrap to aid in detection (stereotaxy) or to guide radiotherapy (radiation therapy)
It is a method of marking with equipment such as.

PTC (Percutaneous Transhepatic Cholangiography) and Gallbladder-Path Interventions
When there is an infection in the gallbladder (cholecystitis), the gallbladder drainage catheter required to drain this section can be inserted (cholecystostomy).
In our department, the use of catheters, balloons or stents of obstructions in the bile ducts, widening (biliary dilatation) and removal of stones
transactions are also possible.

Urinary System Interventions
-Antegrade Pyelography
-Ureteral stenting/Double J catheter insertion

In the accumulation of urine (hydronephrosis) in the kidney as a result of stenosis and obstruction in the urinary tract due to tumor, stone or surgery, healthy kidney
It is the process of removing the urine temporarily or permanently with the help of catheters (nephrostomy) or widening the urinary tract with the help of stents so that it can work.

Dialysis Catheter and PORT Placement
The placement of temporary or permanent (tunneled) dialysis catheters can be performed by the interventional radiology department, accompanied by imaging.
In addition, insertion of venous ports placed under the skin, which can be used in similar situations such as chemotherapy and stem cell transplantation.
can be done with viewing.

RF ablation and Cement Application in bone tumors
Palliative treatment applied to relieve localized pain and prevent bone fracture in cancers of other regions that have spread to the bone causing extreme pain.
purposeful operation. In benign tumors called osteoid osteoma, RF is a non-surgical treatment method with a very high success rate.

Interventional Radiology is located in the Z block.

Communication: 0332 310 50 00 Extension Number: 51252

Our doctors:

Specialist Dr. Necat İSLAMOĞLU

Specialist Dr. Mehmet Çağrı DANIŞMAN

Specialist Dr. Ali Can YALÇIN