THIRUVANANTHAPURAM: The management of vascular diseases, covering a spectrum of conditions impacting blood vessels, used to be elaborate and complicated, necessitating major surgeries that confined patients to the ICU for a minimum of five days. Subsequently, a prolonged period of waiting ensued for the substantial wounds to heal.
The evolution in interventional radiology has instigated a transformative shift in treatment. Notably, patients now experience a shift from the extensive incisions of open surgery to a minute puncture of less than 1 millimeter on their bodies for minimally invasive procedures, resulting in enhanced outcomes and quicker recovery times.
This transformative progress owes much to interventional radiologists, integral in diagnosing and guiding interventions for diverse vascular conditions.
Interventional radiology, equipped with advanced imaging modalities such as magnetic resonance angiography (MRA), computed tomography angiography (CTA), and ultrasound, has revolutionized the precision of vascular disease diagnoses. These technologies provide detailed and non-invasive insights into the vascular system, allowing healthcare professionals to pinpoint the location, severity, and nature of vascular abnormalities.
"The advancement in interventional radiology has contributed to a reduction in procedure complications and hospital stays, leading to significant improvement in outcomes," remarked Dr. Rohit PV Nair, Senior Consultant-Vascular and Interventional Radiologist at Aster Medcity, Kochi.
The spectrum of treatments for vascular diseases spans from unblocking blood vessels to inserting a stent-graft to prevent vessel rupture. Interventional radiologists collaborate closely with endocrinologists, podiatrists, and vascular surgeons for procedures like angioplasty stent placement to treat peripheral vascular diseases (PAD), commonly found in individuals with diabetes, smokers, and those with high cholesterol. Collaboration also extends to cardiothoracic vascular surgeons for addressing artery bulges or aneurysms.
Interventional radiology has refined techniques for treating Deep Vein Thrombosis (DVT), caused by vein clots, offering a more effective alternative to year-long medication. The disease is found in people who are involved in long journeys, women, obese etc. The patients have difficulty in wearing trousers because of the unusual swelling in one of the legs.
“We suck all the clots from the veins and sometimes put a temporary filter to prevent the clot from going into the lungs,” said Dr Nair.
When it comes to clots health experts are concerned about the 20-25% increase in blood clotting incidents after Covid-19 pandemic.
“The pathogenesis of the Covid-19 virus has some effect on blood clotting. As the chances of clotting we are seeing more patients with heart attack, blocks to blood vessels to the bowels, legs etc,” said Dr Nair.
Dr. Manish Kumar Yadav, Senior Consultant, Neuro Interventional Radiology Imaging & Interventional Radiology, KIMSHEALTH, Thiruvananthapuram, emphasized that interventional radiology targets many of today's toughest medical cases, including vascular disease with minimal complications and utmost precision.
“A 48-year-old patient who suffered a severe stroke due to a significant narrowing of a brain artery was presented at the hospital. Traditionally, complex carotid endarterectomy was the norm for such conditions, involving a long surgical procedure, anaesthesia, a scar on the neck, and a lengthy hospital stay.
Considering the complexities, the patient, who was a working professional, underwent a swift and efficient one-hour interventional procedure known as carotid stenting. This minimally invasive approach involved the placement of a small metal stent into the narrowed artery through a minor incision made in the groin, allowing the patient to return home the same day and resume normal life at the earliest. The small incision made, healed quickly and easily within days,” said Dr Yadav.
Despite the sophistication involved the treatments are cost-effective as the patients save on open surgery procedures, ICU and hospital stay.
According to Dr Nair the advancement in Interventional Radiology such as an endovascular robotic system for endovascular aortic repair (EVAR) or Percutaneous endovascular abdominal aortic aneurysm repair (PEVAR) would further reduce the treatment to daycare procedures and the artificial intelligence is expected to better plan the procedures.