Spirotome Bone biopsy for osteolytic lesions under CT guidance

Soft tissue biopsy from osteolytic lesions is a challenge for the interventionist. The Spirotome Bone is conceived for this intervention. The procedure is straigthforward and produces tissue specimens of high quality in sufficient amounts to allow quantitative molecular biology.

Ultrasound-Guided Femoral Nerve Block

Watch an Angiogram Procedure

In this video, Dr. Mark A. Turco, Director of the Center for Cardiac and Vascular Research at Washington Adventist Hospital (Takoma Park, Maryland), performs an angiogram on a female patient with a history of heart disease in her family. Her stress test had indicated that she might have blockages in the blood vessels that carry blood to and from her heart. In his cath lab at Washington Adventist Hospital, Dr. Turco is able to see whether there are blockages and, if so, begin developing a treatment plan for her.

Vertebroplasty with Procedure Demonstration

What is Vertebroplasty :

The vertebral column or backbone tends to get weak as a person gets old. This is more common in women since female hormones are necessary for normal mineralization. The weak bones in the spine collapse, producing painful fractures. Till a few years ago the only treatment that was available for condition was a major surgery. However thanks to interventional radiology today a fractured bone of the spine can be strengthened by injecting a specialized medical cement ( bone cement) into the diseased vertebral body .

Procedure Demonstration :

Stryker Vertebroplasty uses a specially formulated acrylic bone cement to stabilize and strengthen the fracture and vertebral body. Its done on an outpatient basis and requires only a local anesthetic and mild sedation, eliminating the complications that may result from open surgery and general anesthesia. Stryker Vertebroplasty is considered a minimally invasive procedure because it is done through a small puncture in the patients skin (as opposed to an open incision). Technically simple, it usually takes about 30 minutes to complete.

Using sterile technique and fluoroscopic visualization, a 10-, 11- or 13- gauge needle is advanced into the fractured vertebra using a transpedicular approach. Bi-pedicular needle placement is recommended. Once the needles are in the correct position, bone cement is slowly injected into the vertebral body, diffusing throughout the intertrabecular marrow space and creating an internal cast that stabilizes the bone.

Following the procedure, patients lie flat on their back for a short period of time as the cement continues to harden. They may then go home. Almost all patients undergoing Stryker Vertebroplasty experience 90% or better reduction in pain within 24-48 hours and increased ability to perform daily activities shortly thereafter.

Radiation Proctitis

A 70-year-old man presented with a 2-month history of intermittent hematochezia. Ten years earlier, he had undergone 6 months of radiation therapy for the treatment of prostate cancer. The total dose of radiation was 64 Gy, and the prostate cancer was cured.

On physical examination, the temperature was 36.5°C, the blood pressure was 150/90 mm Hg, the pulse was 90 beats per minute, and the respiration was 14 breaths per minute. The abdomen was soft, with normal bowel sounds and without tenderness.
On rectal examination, there were blood clots and friable mucosa that bled easily but no hemorrhoids or palpable masses. The results of analyses of blood and urine were normal.

Colonoscopy revealed fine, tortuous blood vessels and telangiectasias in the rectum (figure). Histopathological evaluation revealed telangiectatic blood vessels with adjacent hyalinization of the lamina propria. Radiation proctitis was diagnosed, and the patient was given argon plasma coagulation therapy.
During 15 months of follow-up, he had mild tenesmus and infrequent, small amounts of hematochezia that did not require further intervention.

liver cancer treated by Radiofrequency Ablation