Interventional Radiology

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The interventional radiology is a relatively new topic in diagnostic radiology (and unlike the Anglo-Saxon countries, it is in Germany still part of the diagnostic radiology) and represents the therapeutic arm of the subject diagnostic radiology. In the interventional radiology under image control (ultrasound, CT, MRI and angiography) therapeutic interventions are carried out, for example in the vascular (e.g. peripheral arterial occlusive disease) and biliary system (e.g. tumorous occlusion of the bile duct system) as well as in parenchymal organs (e.g. radio frequency ablation of liver metastases).


After radiologists learned to depict the human vascular system using special angiography catheters , the idea arose to treat vascular diseases using balloon dilatation or metallic vascular endoprostheses (so-called stents ) in the same way. After the preliminary work of Sven-Ivar Seldinger (1921–1998), Charles T. Dotter (1920–1985) and W. Porstmann (1921–1982), especially Eberhard Zeitler (1930–2011) and Andreas R. Grüntzig ( 1939–1985) turned interventional radiology into a minimally invasive therapy option for cardiovascular diseases worldwide . Interventional radiology then expanded its spectrum to include the treatment of complex clinical pictures (e.g. treatment of portal hypertension as a result of liver cirrhosis using a TIPS ) and the treatment of tumor diseases. Interventional radiology practically always works in close cooperation with colleagues from the fields of anesthesiology , surgery and internal medicine .

Treatment methods

Frequent interventional radiological interventions are:

Vascular Interventions
  • Angioplasty : recanalization of closed vessels by means of balloon dilatation and / or stent . In the meantime, a division of labor has emerged with the interventional cardiologists and neuroradiologists: cardiologists supply the cardiac vessels, neuroradiologists supply the brain and intracranial vessels, and the interventional radiologists all peripheral vessels (including mesenteric and retroperitoneal vessels such as liver and kidney vessels) of humans.
  • Aortic stent: endovascular vascular prosthesis for internal elimination of an aortic aneurysm
  • Cavafilter : Metal filters that are placed in the inferior vena cava , either temporarily or permanently, in order to prevent pulmonary embolism in the event of a thrombosis of the pelvic and leg veins.
  • Chemoembolization : A non-operative therapy for malignant liver tumors : The vessels supplying the tumor are probed with a catheter under fluoroscopy and then a chemotherapeutic agent is applied. The vessel is then closed by embolization . The latter deprives the tumor of the blood supply and ensures that the chemotherapeutic agent remains in the tumor tissue.
  • Embolization : Closing a vessel to treat a malignant or benign tumor (e.g. uterine myoma ) or to stop internal bleeding. There are various embolizates, i.e. materials that are injected into the target vessel through an angiography catheter and are able to seal the vessel: alcohol, gelatine particles, tissue glue (Histoacryl, Ethibloc), metal coils, ethylene-vinyl alcohol copolymer ( EVOH), polyvinyl particles, polymer beads and gel foam.
  • Installation of a transjugular intrahepatic porto-systemic stent shunt (TIPS) for the treatment of portal hypertension as a consequence of liver cirrhosis .
  • Thrombolysis : Emergency treatment procedure for reopening thrombotic, closed vessels by instillation ("injection") of clot-dissolving drugs (urokinase, rTPA) into thrombotically occluded vessels and / or mechanical destruction (usually suction, e.g. by means of the Venturi effect) of the blood clot.
  • Venous access : insertion and supply of special intravenous catheter systems ( central venous catheter , Hickman catheter , subcutaneous port systems )
Tumor Ablation Interventions
  • Cryoablation : Localized destruction of tumors by cold.
  • LITT: Laser induced thermotherapy
  • Radiofrequency Ablation (RF / RFA): Localized destruction of tumors by heat.
  • Interstitial brachytherapy (synonym CT-HDRBT or afterloading): Destruction of tumors by an introduced radiation source.
CT, MRI and ultrasound guided interventions
  • Biopsy : Image-guided tissue removal from all areas of the human body for the purpose of making a fine tissue diagnosis.
  • CT- guided periradicular therapy : pain therapy for radicular pain (e.g. in the case of a slipped disc )
  • Drainage system : Image-controlled installation of drainage catheters for draining inflammable and non-inflammable fluids from the body.
  • Vertebroplasty : Percutaneous injection of bone cement to straighten broken vertebrae.
  • Gastrostomy / gastrojejunostomy: conditioning of nutrition catheters in the stomach or the small intestine.
Biliary interventions
  • Biliary drainage : Diagnostic (PTC) and interventional (PTCD) system of catheters and endoprostheses (stents) for the treatment of benign and malignant biliary stenosis.


  • J. Rösch, F. Keller, J. Kaufman: The birth, early years, and future of interventional radiology. In: J Vasc Interv Radiol. 14 (7), 2003, pp. 841-853. PMID 12847192 .

Web links

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