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Interventional radiology and oncology

The Interventional Radiology Unit is an innovation of modern medicine that treats different pathologies noninvasively: punctures performed under local anesthesia and without cutting the skin can replace or assist the classic surgery. In most cases, the patient is treated in Day Hospital or with a single night of hospitalization.

For more information you can contact the team: radiologia.interventistica@humanitas.it

Below is a list of some conditions that can be treated noninvasively:

  • Abdominal aortic aneurysm
    • Percutaneous aortic endoprosthesis
    • Embolization of an endoleak
  • Visceral and peripheral aneurysms
    • Embolization, stenting
  • Arteriopathy of the lower limbs, diabetic foot, carotid stenosis
    • Angioplasty and stenting
  • Fistula dialysis
    • Revascularization
  • Uterine fibroid, Vascular malformation, Varicocele
    • Percutaneous embolization
  • Gallstones
    • Litholysis with percutaneous laser-assisted video
  • Chemotherapy
    • Positioning venous access and port-a-cath
  • Advanced portal hypertension
    • TIPS: portosystemic shunt
  • Kidney cancer
    • Radiofrequency ablation (RF/MW)
    • Cryoablation
  • Hepatocellular carcinoma, liver metastases
    • Chemoembolization, TAE / TACE
    • Radiofrequency ablation (RF / MW)
    • Radioembolisation
  • Bone metastasis
    • Percutaneous cementoplasty
    • Cryoablation
  • Bile obstruction
    • Percutaneous drainage
    • Absorbable biliary prosthesis
    • Reconstruction of the bile duct

For more information you can contact the team: radiologia.interventistica@humanitas.it

Oncologic Radiology

The service carries out the staging and follow-up of oncological diseases with traditional methods and more advanced methods such as the CT and MRI with high volumetric multilayer field. The Unit is also active in collaboration with the Unit of Nuclear Medicine for hybrid, metabolic and morphological evaluation of oncological diseases through the use of PET, CT and/or MRI imaging.

Interventional Oncology

The prerogative of interventional radiology is to perform diagnostic and therapeutic procedures with a minimally invasive approach, which is done ‚Äč‚Äčthrough the skin using needles and catheters rather than through cuts. The service manages the execution of invasive diagnostic procedures that consist of biopsy withdrawals that are performed under CT, ultrasound and fluoroscopy guidance. In most cases, these procedures are performed in Day Hospital facilities. 

In terms of the therapeutic field, the Unit performs treatments of neoplastic nodules (most often at the level of liver and kidney) through procedures of percutaneous ablation with radiofrequency or microwave needles, or alternative treatments such as trans arterial embolization or chemoembolization. Another treatment option, developed in collaboration with the Nuclear Medicine Service, consists of radio-embolization treatments of the liver. These methods are most frequently used to treat liver metastases and hepatocellular carcinoma nodules. In cases of painful bone metastases it is often possible to perform a percutaneous cementoplasty, or the injection of a cement-like substance that fills the metastases, stabilizes the bone, and any pathological fractures, thus greatly reducing the painful symptoms. For the treatment of pathologies affecting the bile ducts of the liver, the unit performs positioning of percutaneous biliary drainage and in selected cases stenting and biliary prosthesis (both for malignant and benign disease). In the management of patients undergoing surgical procedures of various kinds the appearance of certain infections can be treated through the placement of percutaneous drainage under CT or ultrasound imaging guidance. Moreover, permanent drainages are placed in patients with refractory ascites.  For patients who have to undergo prolonged chemotherapy treatments, the service offers the ability to place devices for long-term infusion (tunnelled CVC and port). In the case of compromise of arteries or veins from inoperable tumors, stents can be placed to insure the vessel patency and prevent a rupture (e.g. stent of the vena cava). 

Treatment decisions involving the unit or service result from the integrated activity of multidisciplinary teams with various skills within the hospital, and they are based on meetings on a weekly basis.

 

Interventional non-Oncology

Interventional radiology within the vascular scope deals with the treatment of obstructive diseases of the arteries in various parts of the body, such as the lower limbs, the renal arteries and carotid arteries. These treatments are carried out by means of simple balloon angioplasty or stent placement where needed. In some selected cases of disease of the lower extremities recanalization and removal of atherosclerotic plaques can be performed using atherotomy systems, always approached with minimally invasive, percutaneous method. This service also performs percutaneous treatments of sympathicolysis, using CT guidance.

Working in close collaboration with Vascular Surgery, this Unit deals with the treatment of aneurysms of the abdominal aorta and chest, by placing various types of aortic endoprosthesis, which are selected based on the particular clinical picture of the patient. Covered, flexible stents that are particularly designed for that area are placed for aneurysms of the popliteal arteries.

Thanks to the sophisticated devices such as covered stents and small metal spirals it is possible to perform the treatment of aneurysm formation that may involve for example arteries of the kidney or the spleen. For patients with vascular malformations, both with high flow (MAV) and low flow, the team deals with the diagnostic phase by highly specific MRA testing; once the treatments are planned, it is possible to perform a treatment of embolization and sclerotherapy (with closure of pathological arteries and veins using dedicated materials, such as endovascular glue). In terms of diseases of the male and female genital tract, the unit also conducts treatments of male and female varicocele, in addition to embolization of uterine fibroids.

The unit is also active in the management of severe liver disease requiring transjugular intrahepatic portosystemic shunt (TIPS). In terms of the management of deep venous thrombosis the unit performs treatments of placing vena cava filters to prevent a pulmonary embolism. 
Thanks to the active collaboration with dedicated Neuroradiologists, one can undergo treatment of intracranial pathology such as cerebral aneurysms and vascular malformations. The service of Interventional Radiology is available 24 hours a day, for all the emergencies that may occur on bedridden patients or patients in the emergency room, performing procedures to stop arterial bleeding (embolization of bleeding). 

All procedures performed by our service can be carried out with the help of dedicated anesthesiologists, who manage the pain by simple analgesia, sedation or general anesthesia. There is also a service of outpatient visits for patients undergoing Interventional radiological procedures that can be evaluated by highly qualified personnel.

 

For more information you can contact the team: radiologia.interventistica@humanitas.it

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