Techniques in vascular and interventional radiology
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Intraductal biliary stones can result in significant acute and long-term complications. When patients' anatomy precludes more traditional management, the interventional radiologist may be called upon to provide well-established techniques for percutaneous biliary drainage and stone removal. ⋯ Direct percutaneous visualization of the biliary tree can also diagnose and provide symptomatic relief for stone-mimicking pathologic conditions such as biliary tumors. This article will review the role, technique, and considerations for percutaneous biliary endoscopy and adjunct interventions in patients with isolated and complex, biliary stone disease and stone-mimicking pathologies.
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Tech Vasc Interv Radiol · Sep 2019
ReviewPercutaneous Interventional Radiology-Operated Endoscopy for Foreign Body Removal.
Image-guided retrieval of endovascular devices such as inferior vena cava filters, guidewires, and stents is well reported, though there is a paucity of published reports on biliary, genitourinary, or gastrointestinal foreign body retrieval utilizing percutaneous endoscopy, particularly when it is performed solely by interventional radiologists. In cases of failed traditional endoscopic techniques or to evade more invasive surgical options, percutaneous endoscopy can be an adjunctive tool employed by interventional radiologists to extract foreign bodies. In this article, clinical evaluation, perioperative management, and procedural techniques for biliary, genitourinary, and gastrointestinal endoscopy for foreign body retrieval are reviewed.
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Tech Vasc Interv Radiol · Sep 2019
ReviewEndoscopy as an Adjunct to Image-Guided Interventions: A New Frontier in Interventional Radiology.
Endoscopy is an underutilized technique in the practice of interventional radiology. The objectives of this article are to discuss potential uses of interventional radiology-operated endoscopy and to outline basic endoscopy setup and equipment uses. Endoscopy represents a new frontier to the fluoroscopically-guided procedures in biliary, gastrointestinal, and genitourinary disease that interventional radiologists commonly perform. ⋯ Endoscopy has been traditionally performed by gastroenterologists and urologists and is relatively new in the practice of interventional radiology. The hand-eye coordination and manual dexterity required to perform standard image-guided procedures places interventional radiologists in a unique position to introduce endoscopy into standard practice. A focused and collaborative effort is needed by interventional radiologists to learn the techniques required to successfully integrate endoscopy into practice.
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Tech Vasc Interv Radiol · Sep 2019
ReviewBeyond the Bile Duct: Advanced IR Endoscopic Interventions Involving the Gastrointestinal, Genitourinary, and Musculoskeletal Systems.
Endoscopy is a technique used by interventional radiology (IR) in only a few centers throughout the United States. When used by IR, endoscopy is most well-known for its role in the treatment of hepatobiliary disease. However, its use with relation to pathology involving the gastrointestinal, genitourinary, and musculoskeletal systems is gaining momentum among IR. ⋯ Nine peer-reviewed articles were identified. While few studies were identified, a general theme suggesting a synergistic relationship between IR and endoscopy was noted. More studies are needed to better understand the role of endoscopy as a technique in the IR suite.
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Tech Vasc Interv Radiol · Sep 2019
ReviewBiliary Endoscopy for Benign and Malignant Biliary Strictures.
Percutaneous endoscopy operated by interventional radiologists has the potential to become an effective tool to both help diagnose and treat benign and malignant biliary strictures. This is particularly true in cases where endoscopic retrograde cholangiopancreatography fails or is not feasible due to surgically-altered anatomy. Both preoperative clinical and technical procedural factors must be taken into consideration when pursuing percutaneous endoscopy. In this article, clinical evaluation, perioperative management, and procedural techniques for biliary endoscopy for benign and malignant strictures are reviewed.