Outline the potential role of interventional radiology in the management of the critically ill patient. Briefly outline the risks involved.

[Click here to toggle visibility of the answers]

College Answer

a)  Interventional techniques may be prophylactic (IVC filter to prevent PE) or therapeutic
(Eg)
1)  Coiling of an aneurysm
2)  Abscess drainage
3)  Embolisation of a bleeding vessel
4)  TIPS procedure for portal HT
5)  Angioplasty for vasospasm
6)  Coronary intervention

b)  May be as effective as surgery, but carry lower morbidity or mortality
Should be considered in ICU patients when the risk of more invasive procedures is greater

Limitations:
1)  Need to be performed in a radiology suite with all its limitations
2)  Might still need surgical back up if there is failure or if there is a complication
3)  Risk of contrast induced nephrotoxicity
4)  Complication specific for each interventional procedure

Discussion

This question is identical to Question 26 from the second paper of 2012.