24 hour emergencies 01332 678333
24 hour referrals 01332 548911

Interventional Radiology & Endoscopy

Interventional radiology and endoscopy is an exciting emerging field in veterinary medicine which makes use of diagnostic imaging modalities such as fluoroscopy and endoscopy to assist with performing procedures by minimally invasive means.

The Advantages of Interventional Radiology & Endoscopic Techniques

These procedures may provide decreased mortality, shorter anaesthesia time, shorter recovery time and reduced hospitalisation when compared with equivalent surgical procedures.

Interventional radiology and endoscopy procedures can also provide treatment options that were not previously available or possible for dogs and cats.

Meet The Interventional Radiology & Endoscopy Team

These techniques and procedures require technical expertise to ensure that are performed safely and effectively. The service at Pride Veterinary Centre has been developed and is run by Hervé Brissot (Soft Tissue Surgery Specialist) and Caroline Kisielewicz (Internal Medicine Specialist).

They have both undergone significant advanced training in this field and combine their areas of speciality to provide a multi-disciplinary, team approach to managing these cases.

Interventional Radiology & Endoscopy Techniques & Procedures

The team are able to perform a wide range of procedures:

Respiratory System

Tracheal stents offer a palliative treatment for tracheal collapse when medical management options have been exhausted. In some cases, the tracheal collapse can be so severe that medical management will have limited positive impact and stenting quickly becomes the treatment of choice. Self-expanding intra-luminal stents are used with preference; the placement of such a stent involves the use of fluoroscopy and is minimally invasive. Amongst patients that have been appropriately selected for the procedure, significant clinical improvement is seen in 80-90% of cases.

Benign or malignant nasopharyngeal strictures can be managed with stricture dilation or stent placement if the stricture were to be refractory to other treatments.

Urinary System

Nephrostomy tubes are used as a temporary measure in cases of acute obstruction of the ureter by ureteroliths. This allows stabilisation of the patient including preventing further deterioration of renal function. Further, more permanent, procedures that may be necessary to bypass the obstruction can then be planned and undertaken as more of an elective procedure.

Subcutaneous ureteral bypass system (SUBS) is used in cases of ureteral obstruction by ureteroliths, strictures or neoplasia in cats and dogs. This technique surpasses the ureteral stent in many cases and particularly in cats and has a low complication rate. It involves placing a shunting port along the ventral abdominal wall and a connecting tube between the kidney of the affected side and the bladder.

Ureteral stents still have their place, particularly in larger patients, where these can be placed in a retrograde manner, through the use of cystoscopy and fluoroscopy, to bypass the obstruction thereby avoiding surgery. In some cases, it is more appropriate to undertake an anterograde approach from the kidney to the bladder to bypass a ureteral obstruction, thereby allowing renal function to be preserved.

 

Colin was diagnosed with idiopathic renal haematuria following visualisation of haemorrhage coming from the right ureter during cystoscopy as part of his investigations into chronic paroxysmal haematuria ongoing for 1 year. As this was predisposing him to repeated urinary tract infections, a mixture containing povidine iodine was instilled in the renal pelvis, by a catheter placed through the ureter, to sclerose the bleeding vessels. This successfully stopped the gross haematuria leaving only minimal microscopic haematuria.

Urethral stents alleviate dysuria and stranguria in dogs and cats with various conditions such as neoplasia of the bladder neck or prostatic tumours, granulomatous urethritis, urethral stricture, reflex dyssynergia and extrinsic urethral compression. In many cases, the stent offers only a palliative solution however with significantly less complication than alternative surgical options such as cystostomy tubes. In cases of strictures, balloon dilation can also be performed under fluoroscopic guidance.

Gastrointestinal System

Balloon dilation is considered the first line approach in cases of oesophageal and colonic strictures in dogs and cats. Stenting of strictures, typically with biodegradable stents, is considered in patients with strictures that are refractory to balloon dilation or in some cases stenting is considered earlier in the treatment phase to prevent multiple repeated dilations and general anaesthetics.

Intra-vascular Procedures

Intravascular procedures (pin hole surgery) have also been adapted from human to veterinary patients. These techniques involve the use of wires and catheters within a blood vessel to access areas that are difficult to reach surgically. Stents can be placed to occlude or improve blood flow.

Coil embolisation of intrahepatic portosystemic shunts involves placing numerous coils in the shunting vessel to occlude the blood flow through this vessel.

Chemo-emobilisation of nasal tumours can also be performed in appropriate cases.

Chemo-embolisation of large non-resectable liver tumours (hepatocellular carcinomas) can be performed to provide drugs directly to the tumour and then block the blood supply to the liver. Chemo-embolisation of nasal tumours can also be performed in appropriate cases.

Embolisation can be used in cases of refractory epistaxis by placing embolic agents in nasal blood vessels to stop the haemorrhage.

Herve is in the process of placing a stent and coils in order to cause embolisation of an intra-hepatic shunt.

Laparoscopy and Thoracoscopy

Laparoscopy and thoracoscopy (keyhole surgery) is a minimally invasive surgical technique which can be used to perform certain procedures such as taking biopsies of liver, pancreas or lymph nodes, performing cryptorchid castration and ovariectomy in the abdomen and partial lung lobectomy or pericardectomy in the thorax. Many other procedures are possible however cases are assessed on an individual basis to determine suitability.

Interventional Radiology & Endoscopy Referrals & Advice

Please do not hesitate to contact Caroline or Hervé at Pride Veterinary Centre to discuss whether your patient would be an appropriate candidate for one of these procedures or whether this would be beneficial for your patient. Email referrals@www.prideveterinarycentre.co.uk

 

Call 01332 548911

Speak to one of our friendly team about how we can help with your pet’s needs.

 

referrals@prideveterinarycentre.co.uk

Email us with any questions you might have and we’ll get back to you as soon as we can.

 

 Connect with us

Get all the latest on what’s happening at Pride Veterinary Centre and the Scarsdale group

Copyright 2018Scarsdale Vets LLP trading as Pride Veterinary Centre, Riverside Road, Derby, DE24 8HX - Company Registration Number: OC350938

Scarsdale Vets
Scarsdale Creds
Website By Forty One Digital