Head of Services
Diagnostic and Interventional Radiology
Diagnostic and Therapeutic Services
The list of diagnostic and therapeutic services available at Radiology as part of the Abdominal Program is focused on the evaluation and treatment of the following conditions:
- Diseases of the abdominal organs.
- Diseases of the gastrointestinal tract.
- Diseases of the genitourinary tract.
- Neoplastic diseases.
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Diagnostic Radiology is also used to assess potential candidates to living organ donation (liver and kidney).
Conditions We Treat
Using state-of-the-art imaging, interventional radiology procedures are a minimally-invasive alternative for numerous conditions, including:
- Liver tumors (locoregional treatment with radiofrequency or microwave ablation, embolization, chemoembolization, radioembolization, and right portal vein embolization prior to the resection of large liver tumors).
- Traumatic or iatrogenic bleeding lesions (embolization).
- Portal hypertension (TIPS, variceal embolization, splenic artery embolization, portal vein recanalization).
- Acute occlusion of arteries, veins, and vascular grafts (thrombolytic therapy).
- Diseases of the pancreaticobiliary tract (drainage procedures, stricture dilation, stone removal, biopsies).
- Diseases of the genitourinary tract (nephrostomy placement, ureteral stricture dilation, stone removal).
- Solid organ lesions or masses (US- or CT-guided biopsies, transjugular liver biopsies).
- Drainage of fluid collections.
- Venous accesses.
- Minimally-invasive vascular and nonvascular procedures supporting solid organ transplants (liver, kidney, pancreas, and lung).
Highly specialized interventional radiology procedures performed include transjugular intrahepatic portosystemic shunt (TIPS). IRCCS ISMETT is one of the Italian centers with the greatest experience in this procedure, having performed more than 1,000 TIPS procedures.
Radiology and Nuclear Medicine
The service supports all clinical activities with advanced imaging for diagnosis, staging, and follow-up of cardiothoracic and abdominal diseases.
IRCCS ISMETT is equipped with state-of-the-art technology for CT, MRI, angiography, and interventional radiology for high-definition diagnostic tests and minimally-invasive procedures. Nuclear Medicine complements these services with functional imaging (scintigraphy, perfusion studies, cardiac imaging, and oncology imaging).
The Service places a strong emphasis on radiation protection for patients and health care providers, a commitment recognized by the EuroSafe Imaging Stars program, which awarded us its highest rating (5 stars).
Conditions Treated with Interventional Radiology
Thanks to state-of-the-art imaging, interventional radiology procedures are offered as a minimally-invasive alternative for numerous conditions, including:
- Liver tumors (locoregional treatment with radiofrequency or microwave ablation, embolization, chemoembolization, radioembolization, and right portal vein embolization to facilitate large liver tumor resections).
- Traumatic or iatrogenic bleeding lesions (embolization).
- Portal hypertension (TIPS, variceal embolization, splenic artery embolization, portal vein recanalization).
- Acute occlusion of arteries, veins, and vascular grafts (thrombolytic therapy).
- Diseases of the pancreaticobiliary tract (drainage, stricture dilation, stone removal, biopsies).
- Diseases of the genitourinary tract (nephrostomy, ureteral stricture dilation, stone removal).
- Solid organ lesions or masses (US – or CT-guided biopsies, transjugular liver biopsies).
- Drainage of fluid collections.
- Venous accesses.
- Minimally-invasive vascular and nonvascular procedures supporting solid organ transplants (liver, kidney, pancreas, and lung).
Highly-specialized interventional radiology at IRCCS ISMETT includes transjugular intrahepatic portosystemic shunt (TIPS). IRCCS ISMETT is one of Italy’s leading centers for this procedure, with more than 1,000 TIPS performed.
Transjugular Intrahepatic Portosystemic Shunt
Patients with chronic liver disease develop increased pressure in the portal vein, the main blood vessel supplying the liver. Increased portal vein pressure causes complications typically associated with liver cirrhosis, such as gastroesophageal variceal bleeding or congestive gastropathy, and the onset of ascites refractory to diuretics. At this stage, patients may require weekly hospital admissions for evacuative paracenteses. Refractory ascites can also become infected, resulting in a condition known as spontaneous bacterial peritonitis. Many of these complications can be life-threatening, with mortality rates reported in the literature ranging from 30% to 50%.
TIPS is an interventional radiology procedure that involves placing an expandable metal prosthesis (stent) between the portal vein and the vena cava. This reduces the increased blood pressure and, consequently, the risk of complications associated with portal hypertension. IRCCS ISMETT is one of the most experienced centers in Italy in performing this type of procedure and collaborates with other Italian and European centers.
The main indications for TIPS at IRCCS ISMETT are gastrointestinal bleeding from gastroesophageal varices, congestive gastropathy, or ectopic varices when conventional treatment with beta-blockers and/or endoscopic therapy is unsuccessful; ascites refractory to diuretic therapy; and Budd-Chiari syndrome, a rare but extremely serious disease affecting young individuals with blood coagulation disorders causing hepatic vein thrombosis. At IRCCS ISMETT, TIPS is also used to restore portal vein patency in patients with portal vein thrombosis.
Recent data from the medical literature show that, in some of these conditions, TIPS increases survival compared with conventional treatments and reduces the number of hospital admissions..
TIPS – Transjugular Intrahepatic Portosystemic Shunt
Staff
- Davide Coppolino
- Giuseppe Cristofalo
- Ambra Di Piazza
- Giovanni Gentile
- Giuseppe Mamone
- Luigi Maruzzelli
- Federico Midiri
- Mariapina Milazzo
- Roberto Miraglia
- Lidia Rabiolo
- Giulia Sollami
- Alessandra Vieni
