Interventional Radiology, Angiology (Vascular Medicine)
Interventional radiology includes methods that allow interfering into blood vessels, particularly the arteries, and solve a wide range of diseases.
Our clinic provides health care in the field of interventional angiology (Endovascular Medicine), performs diagnostic procedures and therapeutic interventions in all arteries and veins except heart. This is primarily the case of lower limb arteries, renal arteries, the arteries of the upper limbs and arteries supplying the head. Recently, there are more venous diseases treated – mainly patients with deep venous thrombosis in ileofemoral area and patients with narrowing of the subclavian vein. Besides the diagnostic examination of blood vessels (angiographic examination) there are performed interventional therapeutic procedures on the affected blood vessels, most often by percutaneous transluminal balloon angioplasty with possible stent implantation, less often various other procedures of Interventional angiology/radiology.
We offer our clients invasive diagnostic and interventional therapeutic procedures performed by endovascular techniques. It is a complete spectrum of peripheral vascular interventions in the arterial and venous system. The surgeries are conducted on a contractual clinic. The contractual clinic has been operating since 2004 and it relies on cooperation with leading experts of university hospitals of the Charles University in Prague, who directly provide these services. All physicians doing interventional procedures are certified in either Cardiology and Angiology or Interventional Radiology and all of them have a licence to perform endovascular procedures and are themselves trainers for these techniques. They went through long-lasting internships in Mayo Clinic in Rochester, MN and Texas Heart Institute in Houston. They regularly publish articles and they are often participants and organizers of seminars and symposia in the Czech Republic and abroad. They lecture at the 1st Medical Faculty of the Charles University in Prague.
All procedures are performed in a specialized catheterization laboratory using angiographic X-ray unit with an option of digital subtraction angiography using contrast substance. Digital images are stored in DICOM 3.0 format and the clinic is connected to the national PACS network. If necessary, vascular surgery is available.
It is possible to set the preoperative diagnosis in the patient’s home country with the cooperation with our contractual experts before arrival. For surgery planning it is possible to use results of earlier tests.
Before treatment the patient will get complete medical examination with the possibility of additional examinations if necessary. Our contractual clinic have all necessary examination methods including computed tomography, magnetic resonance, PET scan and both biochemical and haematological laboratory. They perform diagnostic angiography in all locations except coronary arteries.
The patient is hospitalized in the hospital where intensive care is also offered, when necessary. The patient usually comes a day before surgery and is discharged a day after surgery, therefore it is two nights in the hospital.
The most medically interesting and technically difficult are treatments of aneurysm of the abdominal aorta or pelvic arteries by implanting stent graft (endovascular aneurysm repair).
A stent covered by fabric – stent graft is inserted into a damaged artery through small skin incisions or through completely puncture technique. It seals the bulge on the vessel and prevents from possible rupture of the vessel. During the surgery there are generally used materials of Aorfix company - Lombard Medical, Zenith - Cook, Endurant - Medtronic. Experts of our contracted clinic perform annually about 45 such surgeries. The British manufacturers certify two of them for training other physicians and help manufacturer to implement this method in several European and Asian countries. Recently, these surgeries have been performed completely by endovascular procedures, therefore without help of a vascular surgeon. Thanks to reduction of instrumentarium and possibility of closure of puncture hole in artery (closure devices).
Other top surgeries are solutions of stenosis in arteries supplying the brain, thus carotid and vertebral arteries. Usually made by balloon angioplasty, often with stent implantation, but with the use of modern protectionist devices.
Majority of surgeries are composed of area of treating manifestation of ischemic disease of lower limbs including critical limb ischemia (peripheral obliterative atherosclerosis including critical limb ischemia). This is a reaction to numerous occurrences of this disease in the population. The diagnosis is exactly made at one time (either in our workplace or another) and at second time a surgery is made. Nevertheless, it is also possible to do both during one catheterization procedure usually with help of percutaneous transluminal angioplasty and in appropriate indications with stent implantation. The clinic is also equipped with technologies for patency of thrombotic closures (local catheter-directed pharmacologic thrombolysis, aspiration method, percutaneous mechanical thrombectomy (Rotarex, Aspirex), subintimal angioplasty. However, these methods rather take place in acute conditions. During the surgery materials of Abbot, Biotronik, Boston Scientific, Cook, Cordis, Medtronic, Terumo and others are used.
Angioplasties are more and more in line with global trend of angioplasty performed with the use of drug eluting balloons (DEB).
Our contracting clinic performs annually more than two thousand catheterization surgeries since 2004, many of them prevents from long-lasting pain and even from amputation of endangered limb. It avoids formation of strokes, postpones or treats renal insufficiency and arterial renovascular hypertension. Furthermore, vascular centre treats patients with chronic obliteration of pelvic veins, with uterine fibroids, the superior vena cava syndrome and more. In the field of endovascular recanalization of dialysis shunts it is one of the largest in the Czech Republic.