Interventional Radiology is an innovative approach in medicine that treats different pathologies noninvasively: through punctures performed under local anesthesia and without cutting the skin, the Interventional Radiology specialists can forgo or assist the classic surgery. In most cases, the patient is treated in Day Hospital or with a single night of hospitalization. The Humanitas Department of Interventional Radiology is headed by Dr. Romano Lutman and performs a vast range of procedures.
The Humanitas team carries out the staging and follow-up for oncological conditions, using CT and MRI with high volumetric multilayer field. The team continuously collaborates with the Department of Nuclear Medicine for hybrid, metabolic and morphological evaluation of oncological diseases through the use of PET, CT and/or MRI imaging.
The prerogative of interventional radiology is to perform diagnostic and therapeutic procedures with a minimally invasive approach, which is done through the skin using needles and catheters rather than through cuts. The team routinely carries out CT, ultrasound and fluoroscopy- guided biopsies, which are usually performed in the Day Hospital setting.
In the therapeutic field, the team treats tumors (most often at the level of liver and kidney) with such procedures as percutaneous ablation with radiofrequency or microwave needles and trans-arterial embolization or chemoembolization.
Another treatment option, developed in collaboration with the Nuclear Medicine Department, consists of radio-embolization treatments of the liver. These techniques are most frequently used to treat liver metastases and hepatocellular carcinoma nodules.
The Department provides palliative treatment of painful bone metastases with percutaneous cementoplasty, or the injection of a cement-like substance that fills the metastases, stabilizes the bone, and any pathological fractures, thus greatly reducing the painful symptoms.
The team also manages the pathologies affecting the bile ducts of the liver, positioning percutaneous biliary drainage and, in selected cases, stenting and biliary prosthesis (both for malignant and benign conditions). The team also places percutaneous drainage under CT or ultrasound imaging guidance for patients undergoing various surgical procedures. Moreover, permanent drainages are placed in patients with refractory ascites.
The Department also assists patients that have to undergo prolonged chemotherapy treatments, placing tunneled central venous catheter and port to facilitate drug infusion. In cases of compromised arteries or veins from inoperable tumors, stents can be placed to insure the vessel patency and prevent rupture (e.g. stent of the vena cava).
The team makes treatment decisions based on continuous collaboration with other Humanitas departments, discussing challenging cases with colleagues at weekly multidisciplinary meetings.
Interventional radiology outside of oncology
The team also engages in interventional radiology outside of the oncology. Thus, in the vascular context, it addresses obstructive pathologies of the arteries in various parts of the body, such as the lower limbs, the renal arteries and carotid arteries. The team performs these treatments by means of balloon angioplasty or stent placement, where needed. The specialists also practice minimally invasive recanalization and removal of atherosclerotic plaques, using atherotomy systems, for patients with pathologies of the lower extremities.
Working in close collaboration with the Vascular Surgery Department, the team treats aneurysms of the abdominal and thoracic aorta and by placing various types of aortic endoprosthesis, which are selected based on the particular clinical picture of each patient. For aneurysms of the popliteal arteries, on the other hand, the doctors position special flexible covered stents. Additionally, the doctors deal with aneurysms in the arteries of the kidney and the spleen, using innovative stents and small metal spirals.
The specialists also work with patients with vascular high and low flow malformations, performing magnetic resonance angiogram in the diagnostic phase to then proceed with such treatments as embolization and sclerotherapy, closing pathological arteries and veins using dedicated materials, such as endovascular glue. In terms of diseases of the male and female genital tract, the department conducts treatments of male and female varicocele, in addition to embolization of uterine fibroids.
The team is also active in the management of severe liver disease requiring transjugular intrahepatic portosystemic shunt (TIPS). The doctors treat deep venous thrombosis by placing vena cava filters to prevent a pulmonary embolism.
Thanks to the active collaboration with dedicated neuroradiologists, the team offers treatments for such intracranial pathologies as cerebral aneurysms and vascular malformations.
The Interventional Radiology specialists is active 24 hours a day, for all urgent cases that may occur with inpatients or emergency room patients, responding, for instance, to arterial hemorrhages. The doctors also offer outpatient visits for patients planning to undergo interventional radiological procedures, to deliver highly specialized preventive evaluation.
All procedures performed by the team are carried out with the assistance of specialized anesthesiologists, who manage the pain by simple analgesia, sedation or general anesthesia.