Clinical Activities

Clinical Activities

Department of Diagnostic and Interventional Radiology of University Clinic “High Technology Medical Center” of Tbilisi First Hospital provides Interventional Radiology services to the whole Georgia being the same time the clinical base for TSMU undergraduate and postgraduate Radiology students, for continuing education of medical doctors.

The wide spectrum of Interventional Radiology procedures, being performed in above mentioned department include almost all the manipulations, which exist today throughout the World.

Here is a list of  Interventional Diagnostic and Low-Invasive Treatment Procedures being routinely performed at “High Technology Medical Center” (Using Percutaneal, Vaginal or  Rectal Approach) under Ultrasound, CT, Angiography and  Combined (Ultrasound-Fluoroscopy or  CT-Ultrasound-Fluoroscopy) Guidance

Diagnostic Procedures:

• Fine needle biopsy for cytology
• Core biopsy for tissue morphology (soft tissue, abdominal organs, retroperitoneal space, thorax including mediastinum)
• Diagnostic aspiration of ascitic  fluid
• Amniotic fluid aspiration  for caryotype sampling
• Intraoperative Ultrasound
• Percutaneal cholangiography

Low-Invasive Aspiration-Drainage Procedures

• External drainage of intrahepatic bile ducts (cholangiostomy)
• External-internal  drainage of intrahepatic bile ducts
• External drainage of gallbladder (cholecyctostomy)
• Subdiaphragm abscess drainage
• Liver abscess aspiration
• Liver abscess drainage
• Liver hematoma aspiration-drainage
• Liver cyst (including parasitic) aspiration- drainage
• Percutaneal wirsungostomy (including transgastric approach)
• Pancreatic fluid collections drainage
• Pancreatic fluid collections fine needle percutaneal aspiration via the gastric walls
• Nephrostomy
• Renal cyst aspiration-sclerotherapy
• Infected renal cyst (abscess) drainage
• Tubo-ovarian abscess  (TOA) percutaneal  drainage
• TOA pervaginal and perrectal aspiration-rinsing and drainage
• Ovarian cyst pervaginal and perrectal aspiration
• Prostate abscess perrectal aspiration-rinsing
• Paraproctitis perrectal aspiration-rinsing
• Abdominal wall postsurgery seroma aspiration
• Ascitic  fluid drainage
• Breast cyst aspiration
• Pericardial Space Drainage

Local Ablative Treatment of Masses

• Percutaneal RFA of  tumors
• Thyroid gland node sclerotherapy& Laser destruction

Vessel/Duct Patency Restoration Procedures (Including Endoluminal RFA)

• Bile duct Baloon Dilatation/Stenting
• Wirsung Duct Stenting
• Biliary block recanalisation using Endobiliary RFA&stenting
• Wirsung Duct Block recanalisation using Endobiliary RFA&stenting
• Portal vein thrombus percutaneal thrombodestruction and catheter directed local thrombolysis
• Portal vein thrombus rechanneling  using Endovascular RFA&angioplasty

Percutaneal Litholapaxy Procedures

• Percutaneal  Wirsungolitholapaxy
• Percutaneal Biliolitholapaxy

Anestesia

• Brachial plexus fascial sheath catheterization  for anesthesia

Treatment Procedures under  Angiography  Guidance

• Embolization for Internal bleeding
• Transarterial Chemoembolization (TACE) and Transarterial Embolization (TAE) of liver tumors

November 29, 2009 TSMU and TSMU Interventional Radiology Center (nowadays – above mentioned department of Diagnostic and Interventional Radiology) organized International Conference and Workshop “RFA and Interventional Radiology”

September 03-04, 2010 – Cardiovascular and Interventional Radiological Society of Europe (CIRSE) together with Georgian Association of Cardiovascular and Interventional Radiology (GACIR) organized the ESIR (European School of Interventional Radiology) training course “Biliary and Oncologic Interventions”, which was attended by 56 participants from 7 countries.

CT contr - Percutaneal procedure performed under CT guidance – posterior mediastinum biopsy.

Embolization – procedure performed under digital angiography control to patient with massive bleeding from intraoperatively placed CBD catheter,  caused by intrahepatic arterio-biliary fistula. Selective endovascular occlusion of hepatic artery  8^th  segment branch was performed.

Pancreas -  Post-procedure follow-up.  Posttraumatic necrotic fluid collection due to pancreatitis was drained under combined ultrasound-X-Ray guidance control a week earlier. 

Stenting – transhepatic stenting of the right hepatic duct, performed after bilateral  cholangiostomy.

Ultr.Contr. -  Percutaneal procedure performed under ultrasound guidance – three amebic abscesses of the liver were aspirated and rinsed simultaneously (“barbeque” principle).

TOA – TOA pervaginal drainage, performed under combined (Ultrasound-Fluoroscopy) control

Endobiliary RFA -  percutaneal clearance of biliary block (caused by CBD tumour) performed by percutaneal RFA processing with subsequent ductoplasty

Percutaneal Wirsungolitholapaxy - Wirsung duct stones conduction into the duodenum using balloon - performed  to acute obstructive pancreatitis after preliminary percutaneal Wirsungostomy