INTERVENTIONAL RADIOLOGY

Diagnostic procedures

• Diagnostic angiographies of all organs and systems
• Peripheral angiographies
• Head and neck angiographies
• Extremity angiographies-Functional angiographies
• Bronchial and pulmonary arteries angiographies
• Renal arteries and visceral vessels angiographies
• Peripheral phlebographies
• Cavography
• Superior vena cava phlebography

Interventional procedures

• Balloon and stent angioplasty to arteries and veins, such as iliac, hip and vascular angioplasty below the knee.
• Carotid angioplasty to prevent new brain strokes
• Renal arteries angioplasty to treat hypertension
• Angioplasty and stenting to the superior cava to treat its stenosis, especially in cancer patients
• Filter placement in the inferior vena cava to prevent pulmonary embolism
• Placement of central venous catheters, permanent or temporary, as well as of chemotherapy ports
• Intracatheter embolilzations of neoplasm, hemorrhages, emergency or chronic
• Intracatheter liver chemoembolizations
• Uterine fibroid embolizations
• Varicocele embolizations
• Peripheral vascular dysplasias embolizations
• Peripheral vessels aneurysms repair
• Thoracic aorta aneurysms repair
• Abdominal aorta aneurysms repair
• Obstructive uropathy repair with nephrostomy or internal stent placement
• Percutaneous cholangiographies-drainage of biliary ducts – stent placement
• Restoration of painful skeletal fractures with kyphoplasty-spondyloplasty
• Intravascular catheterization to treat liver tumors and renovascular hypertension

Also, the Department of CT-scans carries out interventional procedures, such as percutaneous cauterization of tumor with radiofrequencies (RF ablation) or microwave ablation and cryoablation, to topically control any malignant diseases.

Fibroid Treatment

Fibroid Treatment Team

The Fibroid Treatment Team at Metropolitan General was established to advise women suffering from symptomatic fibroids about the treatments available in modern Gynecological Surgery and Interventional Radiology.

The Team adheres to all contemporary guidelines and the latest bibliography, ensuring a personalized approach for each woman (considering symptom severity, impact on quality of life, age, fertility intentions, fibroid size and location, personal preferences). Detailed histories are taken, clinical assessments are conducted, and necessary imaging tests (Ultrasounds, MRI) are reviewed. Subsequently, surgical or minimally invasive treatments are recommended for each case, detailing the advantages and disadvantages of each option based on the latest studies and guidelines.

The aim is to inform women with symptomatic fibroids about the available treatments personalized to their specific situation, enabling them to choose the most suitable option. Treatment can be performed at Metropolitan General, where the full range of surgical and minimally invasive methods are provided by the fibroid treatment team doctors.
In Greece, the classic treatment suggested for symptomatic fibroids is hysterectomy, a surgery that induces immediate menopause. Over the past decades, both myomectomy (abdominal or laparoscopic) and uterine artery embolization, which supplies blood to the fibroids, have been developed.

Uterine Fibroid Embolization

Uterine Fibroid Embolization (UFE), often referred to as Uterine Artery Embolization, is a minimally invasive, non-surgical treatment for fibroids. This procedure is performed by interventional radiologists in Interventional Radiology Departments. In the USA and the UK, this method is particularly popular for treating symptomatic fibroids.

During the procedure, blood supply to the fibroids is cut off, leading to their shrinkage and cessation of bleeding. Most women experience immediate results. Unlike hysterectomy, UFE allows a woman to keep her uterus and ovaries, while alleviating fibroid-related bleeding and pain. During embolization, a small catheter, about 1.5 mm in diameter, is placed in the arteries supplying the fibroids. Microparticles, 0.5 mm in size, are injected into the arteries, blocking the vessels and stopping blood flow to the fibroids.

Once blood flow to the fibroids is stopped, bleeding ceases. In the following weeks, the fibroids shrink. Most women experience reduced pain, bloating, and significantly less bleeding. The procedure lasts about an hour, is performed under local anesthesia and mild sedation, and the woman stays overnight in the hospital for optimal pain management, resuming normal activities within a few days.

Myomectomy

Myomectomy (or enucleation of fibroids) is a surgical procedure that removes fibroids from the uterus. It can be performed either via laparotomy or laparoscopically, always under general anesthesia, with women typically resuming normal activities a few weeks later. An advancement in the laparoscopic method is the use of Robotic Systems that guide the camera and instruments, offering high precision, flexible movements, and 3D imaging of internal structures, even in remote areas. Myomectomy is recommended for women who wish to conceive, and its success depends on the location of the fibroids within the uterus.

Another therapeutic method that has significantly developed over recent decades for treating symptomatic fibroids is transvaginal fibroid ablation using radiofrequency under ultrasound guidance. It shows ideal results in small (<5 cm) fibroids and women wishing to conceive.

Team Members:

• Emmanuel Theodoropoulos: Interventional Radiologist, Chief of Interventional Radiology Department, Metropolitan General
• Michael Glynos: Interventional Radiologist, Chief of Interventional Radiology, Metropolitan General
• Nicholas Plevris: Obstetrician-Gynecologist, Chief of the First Gynecology Clinic, Metropolitan General
  

Contact: 210 6502872