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Avascular plane of Brodel

The avascular plane of Brodel is the section of renal parenchyma between 2/3 anterior and 1/3 posterior kidney on the cross-section that is relatively avascular. The reason for its relative avascularity is that it represents the plane where the anterior and posterior segmental renal artery branc...

Retroaortic left renal vein

Retroaortic left renal vein (RLRV) is a normal anatomical variant where the left renal vein is located between the aorta and the vertebra and drains into the inferior vena cava. Its recognition is important in order to avoid complications during retroperitoneal surgery or interventional procedu...

Selective internal radiation therapy

Selective internal radiation therapy (SIRT), also known as transarterial radioembolization (TARE) or hepatic radioembolization, is a relatively new and developing modality for treating non-resectable liver tumors. The procedure consists of a transcatheter injection of radioactive particles via t...

Percutaneous nephrostomy

Percutaneous nephrostomy is a form of nephrostomy in which percutaneous access to the kidney is achieved under radiological guidance. The access is then often maintained with the use of an indwelling catheter. Indications Percutaneous nephrostomy is usually reserved for when retrograde approac...

Iliac artery aneurysm

Iliac arterial aneurysms are focal dilatations of the iliac artery. Although the dimensions that define the aneurysm are dependent on the sex of the patient and the portion of the artery involved, a common iliac artery (CIA) with a diameter ≥1.7 cm in males or ≥1.5 cm in females is considered ...

Ovarian vein embolization

Ovarian vein embolization is an interventional technique primarily used towards the treatment of pelvic varicosities. Indications The main indications are: as part of the management of pelvic congestion syndrome 1-4 to treat pelvic varicosities diagnosed by imaging to treat labial and/or pe...

Percutaneous cholecystostomy

Percutaneous cholecystostomy is the image-guided placement of a drainage catheter into the gallbladder lumen. This minimally invasive procedure can aid in patient stabilization in order to enable a more measured surgical approach with time for therapeutic planning. A 2018 study demonstrated no ...

Medical devices in the abdomen and pelvis

Medical devices in the abdomen and pelvis are important to be recognized, just like medical devices of the chest. We often ignore these devices, considering them to be incidental and non-pathological, however it is essential to be aware of potential complications. Gastrointestinal devices ...

Uterine artery embolization: MRI assessment

Uterine artery embolization (UAE) is used as an alternative to hysterectomy in selected patients and MRI assessment is key in allowing not only pre-procedure assessment but also assessing post-procedural outcome. For a general discussion of the underlying condition refer to the article on ute...

Iofendylate

Iofendylate (generic names: ethyl 10-(4-iodophenyl)undecanoate or iodophenylundecylic acid) and sold under the tradename Myodil (except the USA where it was marketed as Pantopaque) was an oil-based contrast medium used for myelography. The iodine moiety of the compound causes high attenuation ...

Mammotome

MammotomeTM is the brand name for the first vacuum-assisted breast biopsy system. See the article on stereotactic breast biopsy for general discussion of the procedure.

High-intensity focused ultrasound

High-intensity focussed ultrasound (HIFU), sometimes referred to as focused ultrasound surgery (FUS), is a promising non-invasive thermal ablation technique. Unlike diagnostic ultrasound, HIFU focuses the ultrasound waves precisely upon a target. In a similar way to how light can be focused to ...

Cordocentesis

Cordocentesis is a method of fetal blood sampling which is usually carried out under ultrasound guidance. Indications It may be performed for various reasons which include: establish the degree of a fetal anemia further investigation of an underlying chromosomal anomaly further investigatio...

Stereotactic breast biopsy

Stereotactic breast biopsy refers to percutaneous sampling of breast tissue using mammographic guidance for targeting. Indications It is the biopsy method of choice when the finding of interest is best seen on mammography, such as microcalcifications (most common), architectural distortion, or...

Biffl scale for blunt cerebrovascular injury

The Biffl scale or grade illustrates the spectrum of blunt cerebrovascular injury (BCVI) seen on angiography (both CTA and DSA). Some authors refer to the grading scale as the Denver scale, which is not to be confused with the Denver criteria, a series of clinical indications to screen for blunt...

Post-embolization syndrome

Post-embolization syndrome (PES) is one of the most common complications of transarterial embolization and chemoembolisation. The condition comprises a constellation of symptoms including pain, fever, nausea and vomiting. PES usually occurs within the first 72 hours after solid organ embolizatio...

CT guided thoracic biopsy

CT guided thoracic biopsy is usually performed for the diagnosis of suspicious lung, pleural, or mediastinal lesions. It can be performed as an outpatient procedure where patient monitoring and complications support are available. A small percentage of lung and pleural biopsies may be performed...

Caudal epidural injection

Caudal epidural injections, or sacral hiatus epidural injections, are one of several possible spinal epidural injections. Indications Typically, epidural injections are performed in patients who are currently not surgical candidates. The caudal injection can be performed when patients are on ...

Carotid arterial stenting

Carotid arterial stenting (CAS) is a minimally invasive endovascular interventional procedure that can potentially offer the same advantage as surgery (carotid endarterectomy). Indications Indications for carotid stenting are evolving with endarterectomy trials that evaluate the carotid stenos...

Vertebroplasty and kyphoplasty

Vertebroplasty and its balloon-assisted variant, Kyphoplasty, are imaging-guided procedures that involve percutaneous injection of surgical polymethylmethacrylate (PMMA) cement into a diseased vertebral body. Vertebroplasty provides pain relief and strengthens the bone of vertebrae weakened by d...

Interventional procedure article structure

Interventional procedure articles necessarily require a different structure to other articles. It is important for them to have a consistent structure to maintain uniformity across the site. The suggested structure and headings (and heading size) are as follows: ================================...

Liver biopsy (transjugular)

Transjugular liver biopsy (TJLB) is an alternative to a percutaneous liver biopsy in patients with diffuse liver disease, coagulopathy and ascites. It is sometimes done in combination with a transjugular intrahepatic portosystemic shunt (TIPSS) or venography. Indications massive ascites ...

Uterine artery embolization

Uterine artery embolization (UAE) is an interventional radiological technique to occlude the arterial supply to the uterus and is performed for various reasons. History Uterine artery embolization has been practised for more than 20 years for controlling hemorrhage following delivery/abortion,...

Percutaneous transhepatic cholangiography

Percutaneous transhepatic cholangiography (PTC) is a radiographic technique employed in the visualization of the biliary tree and can be used as the first step in a number of percutaneous biliary interventions (e.g. percutaneous transhepatic biliary stent placement) Indications Purely diagnost...

Jugular venous catheters

The internal jugular vein is a preferred site for venous access for large lumen, long-term central venous catheters for chemotherapy, hemofiltration and plasma exchange. These are commonly referred to as (internal) jugular venous (IJV) catheters. Typically, the right internal jugular is used as...

Coil herniation

A coil herniation refers to the part of a detachable coil prolapsing out of the aneurysm and into the parent artery. It is an uncommon complication and is typically seen at the end of the embolization procedure. Contributing factors include 1: wide aneurysm neck instability of the coil in the ...

Pseudocalculus sign (common bile duct)

The pseudocalculus sign is a term coined to describe a mimic of a distally impacted common bile duct (CBD) stone on ERCP, MRCP and the various forms of cholangiography, including T-tube, CT, intraoperative, and percutaneous 1. It results from the forceful contraction of the choledochal sphincte...

Breast ductography

Breast ductography (a.k.a. galactography) is an imaging technique which is used to evaluate lesions causing nipple discharge. It helps in precisely locating the mass within breast tissue and gives useful information for surgical approach and planning. Technique A blunt-tipped sialogram needle ...

MR arthrogram solution

MR arthrogram solution is a gadolinium-containing mixture injected into a joint for MR arthrography. Terminology Fluoroscopy, ultrasound or CT guidance can be used to cannulate a joint, which is then injected with the MR arthrogram solution. MR arthrogram solutions differ in different instit...

Spinal arteriovenous malformations

Spinal arteriovenous malformations (AVMs) are characterized by arteriovenous shunting with a true nidus. They represent ~25% of spinal vascular malformations. Epidemiology Different types of spinal AVM (see below) have different ages of presentation, but overall 80% present between the age of...

Internal carotid artery dissection

Internal carotid artery (ICA) dissection, like arterial dissection elsewhere, is a result of blood entering the media through a tear in the intima 1 and is a common cause of stroke in younger patients. Epidemiology Dissection may occur at any age but is a common cause of stroke in young patien...

Peripherally inserted central catheter

Peripherally inserted central catheters (PICCs), often incorrectly tautologically termed PICC lines, are a type of central venous catheter predominantly used amongst oncology patients and those with chronic diseases (e.g. cystic fibrosis). They offer the ability to have long-term central venous...

Stellate ganglion block

The stellate ganglion block describes blockade of the cervicothoracic sympathetic chain which provides post-ganglionic sympathetic efferents to the head, neck and upper extremities. Neural blockade is typically achieved by deposition of local anesthetic between the prevertebral fascia and longus...

Celiac plexus block

Celiac plexus block under image guidance is an easy and safe percutaneous procedure with good outcomes for pain palliation in patients who have chronic abdominal pain related to the celiac plexus. This usually includes patients with advanced cancers, especially from upper abdominal viscera, su...

Marginal artery of Drummond

The marginal artery of Drummond, also known as the marginal artery of the colon, is a continuous arterial circle or arcade along the inner border of the colon formed by the anastomoses of the terminal branches of the superior mesenteric artery (SMA) and inferior mesenteric artery (IMA). Gross a...

Inferior petrosal sinus sampling

Inferior petrosal sinus sampling is an infrequently used method of confirming the presence of a hormonally active pituitary microadenoma when imaging alone has been insufficient. This technique is able to confirm that excess hormone (e.g. ACTH) is being produced by the pituitary and may also hel...

Upper gastrointestinal bleeding

Upper gastrointestinal bleeding (UGIB) is defined as bleeding proximal to the ligament of Treitz. Epidemiology The incidence of acute upper GI bleeding is ~100 per 100,000 adults per year. Upper GI bleeding is twice as common in men as in women and increases in prevalence with age 5. The demog...

Varicocele embolization

Varicocele embolization is a minimally invasive method of treating varicoceles by embolizing the testicular vein (internal spermatic veins). Indications symptomatic varicocele infertility/subfertility failed surgical ligation Contraindications Relative contraindications include: intraveno...

Varicocele

Varicocele is the dilatation of the pampiniform plexus of veins, a network of many small veins found in the male spermatic cord. It is the most frequently encountered mass of the spermatic cord. Epidemiology The estimated incidence is at ~15% of the general male population and ~40% of subferti...

Endovascular aneurysm repair

Endovascular aneurysm repair (EVAR) was first pioneered in the early 1990s. Since then the technology of the devices has rapidly progressed and EVAR is now widely used as a treatment of thoracic and abdominal aortic aneurysms (AAA). The advantages of endovascular repair over open repair are tha...

Endoleak

Endoleaks are characterized by persistent blood flow within the aneurysm sac following endovascular aneurysm repair (EVAR). Normally the aortic stent-graft used for EVAR excludes the aneurysm from the circulation by providing a conduit for blood to bypass the sac. Epidemiology An endoleak is a...

May-Thurner syndrome

May-Thurner syndrome refers to a chronic compression of the left common iliac vein (CIV) against the lumbar vertebrae by the overlying right common iliac artery (CIA), with or without deep venous thrombosis 2. Although both left and right CIVs lie deep to the right common iliac artery, the left...

Fibromuscular dysplasia

Fibromuscular dysplasia (FMD) is a heterogeneous group of vascular lesions characterized by an idiopathic, non-inflammatory, and non-atherosclerotic angiopathy of small and medium-sized arteries. Epidemiology The prevalence is unknown 7. It is most common in young women with a female to male r...

Transforaminal epidural steroid injection

Transforaminal epidural steroid injections (TFESI), also known as transforaminal nerve root injections or nerve root blocks, are performed for the treatment and diagnosis of radicular pain. They differ from selective nerve root blocks (SNRB), as the aim is to get an "epidural spill" and get the ...

Spinal interventional procedures

Back pain is a common condition that is often difficult to treat. Lumbar degenerative facet joints, lumbar disc disease and sacroiliac joint pain account for nearly 70% of cases of lower back pain. Unfortunately, as the incidence of degenerative changes in the spine is so high (e.g. disc abnorm...

Spinal epidural injection

Epidural spinal injections are one of the more frequently performed spinal interventional procedures. Three approaches to the epidural space exist: caudal epidural injection (via the sacral hiatus) interlaminar epidural injection cervical interlaminar epidural injection lumbar in...

Sacroiliac joint injection

Sacroiliac joint injections can be performed using a posterior approach into the sacroiliac (SI) joint under fluoroscopic or CT guidance. It is often performed bilaterally. Indications diagnostic: relief of pain after injection of local anesthetic therapeutic: to relieve pain from degene...

False aneurysm

False aneurysms, also known as pseudoaneurysms, are abnormal outpouchings or dilatation of arteries which are bounded only by the tunica adventitia, the outermost layer of the arterial wall. These are distinguished from true aneurysms, which are bounded by all three layers of the arterial wall. ...

Classification of endoleaks

Endoleaks occur when an aneurysmal sac continues to be pressurised despite endoluminal stent placement. See the full article on endoleaks here. Classification There are five types: type I: leak at graft ends (inadequate seal) - most common after repair of thoracic aortic aneurysms 4 ...

Caroticocavernous fistula

Caroticocavernous fistulas represent abnormal communication between the carotid circulation and the cavernous sinus. They can be classified as direct or indirect which are separate conditions with different etiologies. Epidemiology Direct caroticocavernous fistulas are often secondary to tra...

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