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Minimally Invasive (non-surgical) Treatments Provided by Interventional Radiologists

Minimally Invasive (non-surgical) Treatments
Provided by Interventional Radiologists

As vascular & non-vascular experts, interventional radiologists help women avoid needless suffering by providing minimally invasive treatment options. For many years, surgery was the only treatment available for many conditions. Today, interventional radiology treatments are first-line care.
Interventional radiologists often treat women by non-surgical treatment options for many diagnosed/ misdiagnosed condition such as: -  

  • Chronic pelvic pain (Pelvic congestion syndrome)
  • Uterine Fibroids
  • Uterine Adenomyosis
  • Blocked Fallopian Tubes
  • Osteoporosis (now treated by Vertebroplasty)
  • Varicose Vein in legs
  • Lower limb vascular disease.
  • Un-operable Liver tumor
  • O3 therapy for slipped disc.

1) Chronic Pelvic Pain (Pelvic Congestion Syndrome)

It is estimated that one-third of all women will experience chronic pelvic pain in their lifetimes. Many of these women are told the problem "is all in their head," but recent advancements now show the pain may sometimes be due to hard-to-detect varicose veins in the pelvic area, known as pelvic congestion syndrome. The minimally invasive outpatient / day care procedure seals the faulty vein using embolization.

Picture 1: - USG Doppler study of pelvis shows prominent ovarian veins.
Picture 2: - Ovarian vein venography shows dilated veins in pelvis cause of chronic pelvic pain.
Picture 3: - Shows blocking of dilated ovarian vein by multiple coiles.

2) Uterine Fibroids

Uterine fibroids are very common non-cancerous (benign) growths that develop in the muscular wall of the uterus. Although hysterectomy, performed by a gynecologist, is the most common treatment for symptomatic uterine fibroids, most women are candidates for the uterine fibroid embolization (UFE), a widely available non-surgical option. UFE, also known as uterine artery embolization, blocks the blood flow to the fibroid tumor, killing it and causing symptoms to subside

Interventional radiologist treats uterine fibroids nonsurgically with Uterine Fibroid Embolization

3) Uterine Adenomyosis

Adenomyosis is a disease which involves the uterus and it has long been an underdiagnosed condition of the uterus. And about 30% of uterine fibroids are associated with Adenomyosis (bulky / enlargement of uterus). Adenomyosis is the presence of uterine lining tissue (endometrium) deep within the myometrium (muscular wall) of the uterus causing enlargement of the uterus.  

The ultrasound imaging often fails to distinguish the two conditions. Diagnosis of these conditions is done by ultrasonography and modern imaging techniques like MRI. 

In India most of the patients still depend on their family doctors & consulting gynecologist for their complete medical information. And many women unfortunately have to undergo hysterectomy (surgical removal of uterus) thinking that no other treatment is available for their uterine problem even if they are young without knowing the complication of these major surgeries. While in USA & Europe, people now go through internet for getting best information & hence can chose the best possible treatment options.

Till now the only treatment available for adenomyosis was medication, which if did not help, then patients were forced to undergo surgical removal of uterus (hysterectomy) but these are the major surgeries with height rate of complications like recurrence, sudden menopause, obesity, emotional trauma and loss of libido.

But now a very effective, easier then abortion & patient-friendly non-surgical technique called “Uterine Artery Embolization” is available that requires only 12-24 hrs hospitalization, no risk of anesthesia, no surgical scar on abdomen, short recovery than from hysterectomy or even laparoscopic surgery, all fibroids & adenomyosis are treated at one sitting, no blood loss or risk of blood transfusion, resolution of heavy bleeding in majority, within 24 hours. Not only this, even uterus will remains in the same position. Emotionally, financially and physically , embolization has an overall advantage over laparoscopic surgery. Uterine artery embolization treatment is easier then simple abortion technique and worth trying if women want to save the uterus and to avoid major surgery like hysterectomy.

4) Opening of blocked Fallopian Tubes 
Infertility affects lakhs of couples in India. In females, blockade of fallopian tubes are the most common causes of infertility and is seen in 30-40% of these couples.
Due to lack of awareness about non-surgical treatment, patients frequently undergo surgical treatment, which results in surgical scar, long hospitalization, chances of infections, and done under general anesthesia.

The opening of blocked fallopian tube procedure examination is done 8 to 11 days after the first day of the patient’s last menstrual period.  In the same sitting the interventional radiologist performs this treatment also. He inserts a thin tube inside the uterus and very thin platinum wire passed through the fallopian tube on both sides under vision of high-end digital monitor. Patient can watch the entire procedure on computer monitor. The procedure usually takes 30 to 45 minutes and patient can go home after one hr.

Dr.Pradeep Muley M.D. Head and Senior Consultant Interventional Radiologist at Fortis hospital, New Delhi trained from John’s Hopkins Medical Institutions USA and Singapore general hospital says this non-surgical treatment for varicoceles & opening of blocked fallopian tubes is now becoming popular in India like in western countries.

5) Osteoporosis

Vertebroplasty is a pain treatment for vertebral compression fractures that fail to respond to conventional pain therapy. Vertebroplasty, a nonsurgical treatment performed by interventional radiologist using imaging for guidance, stabilizes the collapsed vertebra with the injection of medical-grade bone cement into the spine

6) Varicose Veins

Venous insufficiency is an abnormal circulatory condition in which the valves in the vein that pump the blood back up to the heart become weak and don’t close properly, thus allowing blood to flow backwards down the leg (called reflux). Varicose veins are prominent veins that have lost their valve effectiveness and, as a result of dilation under pressure, become elongated, rope-like, bulged and thickened. Interventional radiologists treat varicose veins non-surgically using vein ablation , they seal the faulty vein closed using heat.


7) Women & Vascular Disease

Peripheral arterial disease (PAD) , clogged or narrowed arteries in the legs , is a red flag that the same process may be going on elsewhere because atherosclerosis is a systemic disease and associated with other life-threatening diseases. Through early detection, the progression of vascular disease can be halted, saving women from future stroke, heart attack, and early death if PAD is detected early. 

8) Minimally Invasive Ozone-Oxygen Therapy for slipped disc.

Oxygen-ozone therapy is one of the most effective minimally invasive treatments currently available. Actions of ozone are: -

  • Reduction in herniated disk volume, as disk shrinkage may reduce nerve root Compression.
  • Disk shrinkage may also help to reduce venous stasis caused by disk compression of vessels, thereby improving local microcirculation and increasing the supply of oxygen. This effect has a positive effect on pain as the nerve roots are sensitive to hypoxia.
  •  Immunomodulating action
  • Analgesic and antiinflammatory effects
  • Administering medical ozone followed by injection of a corticosteroid and an anesthetic at the same session gives better result.

Indications: ,

  • Clinical signs of lumbar disk nerve root compression,
  • CT and/or MR evidence of contained disk herniation.
  • Chronic joint pain and swelling.

Success rate: 70.- 80%


09) Minimally Invasive , Percutaneous vertebroplasty for painful fractured vertebral body.

Percutaneous vertebroplasty is a newer non-surgical technique in which a medical grade cement is injected though a needle into a painful fractured vertebral body. This stabilizes the fracture, allowing most patients to discontinue or significantly decrease analgesics and resume normal activity


Which is best treatment option