When is this exam indicated?
These interventional procedures are indicated in cases of:
- bile duct obstruction or to describe the course of the ducts - Percutaneous transhepatic cholangiography (PTC) - and drainage placement;
- placement of an internal–external catheter or a biliary stent which helps drain the bile to the intestine;
- to explore the urinary excretory system in cases of stenosis/obstruction and place decired drainage;
- to guide biopsies of tumors or other suspicious lesions through imaging guided biopsy with the aid of CT, MRI, X-rays, ultrasound or fusion techniques;
- in treating hepatic, renal and lung primary and secondary cancers using microwave or radiofrequency ablation.
How is it performed?
These procedures are generally performed in the angiographic suite. Patients will be administered a local anesthetic. Vascular structures may be studied during the procedures with the aid of a radio-opaque constrast medium. Deep sedation may be needed. These exams are not performed as out-patient procedures. Generally, for these procedures, blood count, creatinine and coagulation tests may be required.
Most common rare side effects are those linked to damage of adjacent vessels or structures, allergic reaction to contrast agents used during the procedure. Please inform the doctors in case you are taking specific medication and in case you are takinganti-aggregant or anti-coagulant medication. All patients need to fast, depending on the procedure, for a tleast 12 hours. Water intake is permitted if the procedure is carried out with local anesthesia alone. This procedure may use x -rays that produce radiation called "ionizing" radiation, that can induce damage to biological tissues. Radiation is needed to obtain diagnostic images . In order to minimize this risk as much as possible, for each examination with radiation we check whether it is really necessary (principle of justification) and, if so, we use the lowest possible radiation dose that allows us to obtain the best result (principle of optimization). The maximum optimization of our equipment is ensured by the constant control of a Specialist in Medical Physics that guarantees the maintenance of maximum efficiency. Women of childbearing age must exclude pregnancies in progress. In case of pregnancy, even if only suspected, it is essential to notify the physician, who will assess the advisability of the examination and, if the assessment of the risk-benefit ratio proposes its execution, will need to require an additional appropriate consent and notify the staff for the necessary precautions.