Tom

Cirrhotic patient with fundal varices and large PSS prior endoscopic flue injection now presented with massive upper GI bleed. Hb 6. Shunt occlusion with Double plugs - no further bleeds # Pinhole treatment for upper GI bleed @ISVIRIndia @No_cut_surgery @keithppereira @SRajesh_IR

@uditchauhan__dr @dralokudiya @No_cut_surgery @SRajesh_IR @ISVIRIndia @DrAjityadav @somubetageri What needle did you use to puncture the lesion? Glue : Lipiodol ratio 1:2 ?

Large hypervascular tumor of leg having multiple tiny feeders. Embolised with percutaneous injection of glue and lipiodol(50%). Distal flow is preserved. Never forget to apply tourniquet and trap the lesion in such cases.

@ajgunnmd @TzeWah1 @salilkarkhanis @GarnonJulien @MountSinaiIR @bonesz @dcmadoff @TimMcClureMD @uab_ir @FiveNada @kantonIR Nicely done. What particles (& size) did you use for embolisation @ajgunnmd ?

T1b renal cell carcinoma in a non-surgical patient embolized from a trans-radial approach prior to percutaneous cryoablation by #IRad. Typically, we would do both procedures the same day but I am hopeful for some size reduction of the mass to make ablation a little easier.

Case 2 : Elderly with solitary cancer in right lobe of liver with subcapsular extension - microwave ablation - complete response on follow up. #interventional oncology #pinhole #irad @ajgunnmd

Managing cancer-related diseases through pinhole Case1 Middle aged man with abdominal pain & wt. loss under evaluation. CT abdomen - small bowel circumferential short segment wall thickening. Image guided biopsy HPE:poorly differentiated malignant neoplasm @bhavinj @DrAjityadav

@DrAjityadav @pairsmedia @No_cut_surgery @IR_juniors @ISVIRIndia @jcir_journal @alokmittaldr @drgauravgangwni @keithppereira @SIRRFS @ETF_IRtrainees Subclavian vein pseudo aneurysm? Possibly related to venous catheterisation

Can anyone Guess the procedure ? @pairsmedia @No_cut_surgery @TomG_IR @IR_juniors @ISVIRIndia @jcir_journal @alokmittaldr @drgauravgangwni @keithppereira @SIRRFS @ETF_IRtrainees

@SRajesh_IR @theliverdoc @ISVIRIndia @RizwanAZ1987 @SHOBS108 @AnilLam21050788 @DrTarunSJ @Sandeep11593961 @ganeshd_VIR @uditchauhan__dr @SudheerPargewar @DrUdiya @No_cut_surgery Excellent thinking and execution 👏👏

Transjugular Intrahepatic 𝗕𝗶𝗹𝗶𝗮𝗿𝘆 Stenting (TI𝗕S) 64y/M, Inoperable pancreatic carcinoma with biliary obstruction & gross ascites. Failed ERCP. Biliary system accessed through right hepatic vein via jugular approach. Tract closed with gelfoam. @theliverdoc @ISVIRIndia

@keithppereira @SRajesh_IR Thank u 🙏. I know its bit deep, but it was an emergency sir. I had only single length uncovered stent in stock plus he was not a transplant candidate.

@TomG_IR @SRajesh_IR Great clinical result for this patient! Curious as to any reason the stent was extended so deep into PV?

Cirrhotic with 6 th episode of bleeding on repeated endoscopic treatment. As bleeding was not getting controlled on endoscopic therapy, TIPS procedure was done as salvage treatment. Patient extubated on next day of procedure 🙂 - Believers hospital @SRajesh_IR @keithppereira

@RajivSharmaDr2 @SRajesh_IR @keithppereira Thanks. Dilated upto 10 mm

@TomG_IR @SRajesh_IR @keithppereira Great Result. Was the Stent Dilated to 8 mm or 10 mm and what was post Procedure Shunt Gradient

@SRajesh_IR @DrAjityadav @ISVIRIndia

31 yr old lady presented with snoring during sleeping with lump in the floor of mouth and was diagnosed to be case of low flow vascular malformation (~3 cm) on MRI. Underwent 3 sessions of Intralesional Bleomycin Sclerotherapy and on follow up has complete clinical improvement:)

@ajgunnmd @eruckinator @amdevane @uab_ir @CHICKVIR @medravi @hsinghIR @gargtushark @AhsunR @Yale_IR @parkhurst42 Nice one @ajgunnmd 👏 What was the sheath size needed for cholangioscopy ? Did u have to place a smaller sheath initially and then upsize sheath size at a second stage?

Biliary stricture after a Whipple surgery due to pancreatic #cancer, with prior brush biopsies being non-diagnostic Interventional radiology (#IRad) used a combination of fluoroscopy and biliary cholangioscopy to localize and biopsy the stricture, which was benign

@RajivSharmaDr2 @SRajesh_IR @DrAjityadav @ISVIRIndia @satheesh_ir Hi, I would b more than happy to share with u :) used only vascular plug with no gelfoam - it was a large shunt - used the largest available Amplatzer plug (22 mm) as there was a neck towards the efferent drainage site. 9 F long sheath with C2 catheter to cannulate the shunt

@TomG_IR @SRajesh_IR @DrAjityadav @ISVIRIndia @satheesh_ir Request if you could share some technical details like Sheath length , French size , Diagnostic catheter used , gel foam slurry volume to get such wonderful Post Procedure results.

Incidentally detected large varix about 4 cm size, size of a small lemon. PARTO done as primary prophylaxis gastric variceal bleeding CECT today after 4 week: shunt completely obliterated, portal vein size improved, no ascites:) @SRajesh_IR @DrAjityadav @ISVIRIndia @satheesh_ir

@RajivSharmaDr2 @SRajesh_IR @DrAjityadav @ISVIRIndia @satheesh_ir Cook - Mullins sheath

@TomG_IR @SRajesh_IR @DrAjityadav @ISVIRIndia @satheesh_ir What size long sheath used and which one . Is it Cook Ansel Flexor or some other sheath

Single-session thrombectomy and bifurcated stent reconstruction of splenoportal axis for chronic splanchnic venous thrombosis, bowel ischemia and variceal hemorrhage. With @somubetageri @drabbyphilips @ISVIRIndia

73 yr old male with hematuria & obstructive uropathy. Anuria at the time of IR referral - bilateral nephrostomy followed by antegrade ureteric stenting. Came for follow up after 2 weeks - bladder output daily ~ 2 litres :) Not a very complex case, but a rewarding one @ISVIRIndia