1. Consultation and management of all peripheral vascular diseases including peripheral angioplasty stenting , wound management , and medical peripheral vascular disease management.
2.Uterine Fibroid embolization: A viable alternative for hysterectomy for fibroid management.
3.Renal Denervation : Method of denerving the renal afferent nerve supply in resistant hypertension, minimally invasive method of decreasing BP thereby decreasing need for prolonged medication.
4.Prostatic artery embolization : Excellent alternative to TURP, in reducing the prostatic volume by reducing the prostatic blood supply, mostly used in very aged patients who are poor risk for general or spinal anesthetic .
5.Complete Percutaneous liver, lung, and renal tumor, management : Consisting of radiofrequency ablation of liver and renal tumors, along with transarterial therapies for the liver cancers.
6.Bone, spine and pain management interventions :Radiofrequency ablation of osteoid osteoma, ozone disc lysis, facet blocks, transforaminal epidural blocks, radiofrequency ablation of painful facets. These are very well performed by interventional radiologist as they are well versed with identifying the cause of pain on MRI.
7.Vertebroplasty and osteoplasty of painful vertebrae and sacrum.
8.Stent grafting and management of all kinds of abdominal and thoracic aneurysms.
9.Embolization service : Bronchial artery embolization , Uterine artery embolization for post partum hemorrhage, pre-procedure embolization of tumors like juvenile angiofibroma, RCC.
10.Transjugular intrahepatic portosystemic shunting for refractory ascites and upper GI bleeding.
11.Urology: Percutaneous nephrostomy in cases with undilated or dilated pelvicalyceal system, varicosecele embolization.
12.Nephrology interventions: Difficult renal biopsies, placement of all kinds of dialysis catheters, angioplasty of dialysis fistulae and grafts, declotting of fistulae, angioplasty and stenting of central venous narrowing.
13.Second opinions on all forms of radiological imaging and biopsy service, that caters to the needs of the clinical situation.
14.Complex abdominal and thoracic drainage procedures.
15.Neurological procedures : RF ablation of trigeminal neuralgia, carotid artery stenting, acute stroke thrombolysis.
If you suffer from problems related to veins, such as varicose veins, spider veins, venous ulcers, deep vein thrombosis, you need not feel worried or alone. These are amongst the commonest vascular problems. While some people may seek help for cosmetic reasons, most seek relief from pain, ulcer or leg swelling. Whichever category one may be in, help is available. This section deals with varicose veins.
Varicose veins have existed since man assumed the upright posture. That is, when gravity simply inhibited venous return from the legs. The oldest record of venous disease was found on a votive tablet that was dedicated to the gods by a Greek citizen with the hope of healing his varices. Up to the end of 18th century, varicose veins were considered a local disease and were cauterized. Their relationship with the circulatory system was only suspected. After the Second World War, advances in surgical techniques gave a new impetus to surgery for varicose veins.
The past decade has witnessed a renewed interest in the field of venous diseases. To a great extent, this has been the result of the technological revolution in the field of non-invasive vascular diagnosis, and of a better understanding of the pathophysiology of venous disorders of the extremities.
Varicose veins are dilated, elongated and tortuous veins visible through the skin, usually on the legs and thighs.
A basic knowledge of the venous system will enable us to understand varicose veins better. Fluids normally flow according to a gradient of height, like a mountain stream, downward, or according to a pressure gradient, as in a water supply system, from points of higher pressure to points of lower pressure. This latter principle applies to the whole circulatory system.
Veins are tubes that carry blood from the extremities and various organs, back to the heart. The one-way valves in the veins allow blood to flow only upwards and from the superficial to the deep veins.
When one walks, the blood flow in the calf muscles can increase 40-fold. At this time, the calf muscles work like a suction and pressure pump to transport this increased volume of blood to the heart. The resting pressure in the erect posture in the veins at the ankle ranges from 70-90 mm of Hg. The constant siphoning of blood during walking results in a fall in the peripheral venous pressure. This ambulatory venous pressure falls to about 30 mm of Hg by 8-10 steps of walking and remains low throughout the period of muscle pumping.
Venous problems occur due to morphologic damage to the veins or their valves, which results in the impairment of the harmonic interplay of the leg vein pump. The pressure does not fall sufficiently during walking, resulting in what we may call ambulatory venous hypertension.â€ The pressure remains above 30 and may be up to 90 mm of Hg even while walking. The inability of a diseased valve to close results in back flow of blood, resulting in the formation of primary varicose veins. Acute thrombophlebitis can destroy the valve and lead to post-thrombotic varices and chronic venous insufficiency. The increased pressure in the veins around the ankle leads to swelling, skin changes, eczema and ulceration. The varices may get thrombosed leading to severe pain or a varix may rupture leading to bleeding. These abnormal veins may be associated with pain, feeling of tiredness, fatigue, heaviness, aching, itching, burning, cramping and restlessness of the legs.
The incidence of venous problems is higher in the Western population, compared to the Asians. However, it is of significant magnitude in our country. Heredity is the most important contributing factor in causing varicose veins. Women are more likely to suffer from vein problems. Hormonal factors including puberty, pregnancy, menopause and the use of birth control pills affect the disease. Many pregnant ladies develop varicose veins in the first trimester. They usually subside within 3 months after delivery. Other risk factors include aging, standing occupations, obesity and leg injury.
The diagnosis of venous problems is simple but needs a sensible evaluation to plan the appropriate treatment. While varicose veins and spider veins are visible, the exact underlying problem may not be seen without tests like Duplex scanning and Venous Plethysmography. These tests allow the Vascular Surgeon to study the disturbed morphology and its functional impact. These tests can also be used to assess the outcome of treatment. Venography (Venous angiography) may rarely be necessary in selective circumstances.
All varicose veins do not need treatment. Veins that are cosmetically unappealing or cause pain or other symptoms should be treated. Veins associated with ulcers, bleeding, hyper pigmentation and eczema must be treated.
Contrary to the popular belief that varicose veins should not be treated surgically, the present day treatments are very effective. In many situations, the disease may not be curable, but is controllable to enable you to lead a healthy, active and good quality of life.
The treatment of venous diseases is an art that has to be learned. There are scientific principles to be followed and tricks to be used to get the best possible outcome. Each patient has to be individually evaluated and the most suitable option or a combination may be used.
The treatment modalities may be conservative like medical therapy and compression stockings, life style changes, or corrective like injection sclerotherapy, endoscopic or open surgery and LASER ablation. Today, LASER ablation is considered to be possibly the best option with a low risk of recurrence.
A few commonsense tips are the key to a healthy, active life in spite of varicose veins. Exercise improves the function of the muscle pump. Jogging, swimming and cycling are all great exercises, but walking is even better. Walk with stockings for healthy legs. Put your legs up while sitting and raise your legs in the bed at night. These manouvres help to empty the veins and reduce swelling. Watch your weight. Being overweight worsens the symptoms of varicose veins, makes treatment more difficult and increases the risks of surgery. Slim down and make things easier for your doctor. Needless to say, you will look and feel better. Use elastic stockings prescribed by your doctor.
Remember the 3 is for healthy legs: Exercise, Elevation, Elastic support.
If you have a venous problem, do not resign to fate. Effective help is at hand to assure you of a good quality of life.
Varicose veins remain a common and bothersome problem. Surgical therapy has generally resulted in good outcomes. However, there is a reasonable incidence of recurrence after a few years.
Endovenous therapies have been developed to try and overcome these issues. These include:
We now have the experience of having treated over 100 limbs with varicose veins using endovenous laser therapy. The success rate has been 99%. We had to convert to open surgery in one limb since the laser fiber could not be negotiated. All treated patients have the expected outcome with 100% ulcer healing rate. We have combined laser therapy with ligation of perforators and excision of varicosities to give the best outcome to the patient.
The GSV is entered using a sheath over a guidewire. The laser fiber is introduced through the sheath and positioned 1 cm below the SFJ. Perivenous infiltration of saline is done to protect the surrounding tissues. The vein is ablated by firing pulses of laser energy. The thermal energy results in obliteration of the vein.
We use the latest dual wave length laser machine with double ring jacketed radial fiber which is currently best and the safest system available.
Embolization refers to the passage of an embolus within the bloodstream. It may be pathological, for example as a surgical complication, or therapeutic, as a treatment for bleeding or some types of cancer by deliberately blocking blood vessels.
Therapeutic embolization is a nonsurgical, minimally invasive procedure performed by interventional radiologists and interventional neuroradiologists. It involves the selective occlusion of blood vessels by purposely introducing emboli, in other words deliberately blocking a blood vessel. Embolization is used to treat a wide variety of conditions affecting different organs of the human body.
Head, neck and spinal tumours (or growths) can occur on the coverings of the brain called meninges as well as anywhere in the head or neck region. These tumours can also occur in the back bone (spinal column). Structures inside the spinal column such as nerves can also give rise to tumours.
Often these tumours contain many blood vessels and could result in severe blood loss during an open surgical operation to remove them. The aim of embolisation is to block as many of the blood vessels as possible so that there is reduced blood loss during surgery making it safer, technically easier for the surgery to be performed, and sometimes quicker.
Uterine fibroid embolization (UFE) is a procedure done by an Interventional Radiologist. It blocks blood flow to fibroids in the uterus. (It is also called uterine artery embolization.) For women who are not planning a pregnancy in the future, UFE is a possible option in place of surgery for fibroids.
Follow your doctor's instructions exactly about when to stop eating and drinking, or your procedure may be canceled. If your doctor has instructed you to take your medicines on the day of your procedure, do so using only a sip of water. About an hour before the procedure, you may be given a sedative to help you relax. It will not put you to sleep, because it is important that you be awake to follow instructions during the procedure.
First, a thin, flexible tube called a catheter is placed into a blood vessel in the upper thigh (femoral artery). A substance called contrast material is then injected into the catheter. You may feel a warming sensation as it travels up to the uterus. The radiologist uses real-time X-ray on a video screen (fluoroscopy) to see the arteries and then guides the catheter to the arteries that supply blood to the fibroid. A solution of polyvinyl alcohol (PVA) particles is injected into those uterine arteries through the catheter. These particles build up in the targeted arteries and block blood flow to the fibroid.
Uterine fibroid embolization usually takes between 1 and 3 hours, depending on how long it takes to position the catheter and how easy it is to position the catheter in the arteries in the uterus. When the procedure is over, the catheter is removed and pressure is applied to the puncture site for 10 to 15 minutes, unless there are problems with bleeding. A bandage is then applied. You can expect to have at least 6 hours of bed rest after the procedure.
You may be sent home after the bed rest period if your pain is under control, or you may spend the night in the hospital for more observation or pain control. This will depend on your radiologist's normal practice. And it will depend on how well you do after the procedure.
Ablation means “destruction “or “detachment”. Thermal ablation is the most frequently employed ablation technique. There are three types of thermal ablation.
Radiofrequency ablation (RF ablation) : In this procedure an interventional radiologist guides a small needle through the skin into the tumor. Radiofrequency energy is transmitted to the tip of the needle, where it produces heat and kills the tumor near the needle. The tumor remains as a mass or scar of dead tissue RF ablation is ideal for nonsurgical candidates and those with smaller tumors.
Embolization is a well-established interventional radiology technique that uses small solid particles or special liquid agents to block the flow of blood. This can be used to treat trauma victims with massive bleeding, to control hemorrhage after childbirth, to decrease blood loss prior to surgery and to treat tumors. Embolization procedures are most frequently utilized for liver tumors.
Arterial Embolization: In treating cancer patients, interventional radiologists use arterial embolization to block the blood supply to the tumor. By starving the tumor of the oxygen and nutrients within the blood, the cancer cells will not survive.
Chemoembolization : Chemoembolization delivers a high dose of cancer-killing drug directly to the tumor of its blood supply (chemotherapy). The embolic agents keep the chemotherapy drug in the tumor by preventing its flow to the tumor and subject the rest of the body to less chemotherapy.
Radioembolization : Radioactive materials (typically in the form of small microsphere) are injected into the blood supply feeding the tumor. The concept is to achieve call death by delivering a high dose of focused radiation to the tumor.
Treating patients with cancer requires a team approach. Working with medical and surgical oncologists, interventional radiologists aim to help cancer. Tumor ablation procedures are intended to treat small, less advanced cancer stage. These minimally invasive techniques are often employed at a more advanced cancer stage. These minimally invasive techniques are often considered palliative, not curative. The intent of these procedures is to enhance the quantity and the quality of life by preventing cancer growth and spread while reducing pain or other cancer-related symptoms.
Urology is a surgical specialty which deals with diseases of the male and female urinary tract and the male reproductive organs. Although urology is classified as a surgical specialty, a knowledge of internal medicine, pediatrics, gynecology, and other specialties is required by the urologist because of the wide variety of clinical problems encountered. In recognition of the wide scope of urology, the American Urological Association has identified seven subspecialty areas:
Historically, the subject which clearly established the specialty of urology as being distinct from general surgery was the treatment of obstructive uropathy. This treatment ranges from the correction of obstructing posterior urethral valves or ureteropelvic junction obstruction in the infant to the correction of bladder outlet obstruction from benign prostatic hyperplasia in the older male. Through the decades, we have witnessed a tremendous increase in our general understanding of the diverse functional disorders of urine transport associated with various overt and covert forms of neuromuscular dysfunction. The rapidly evolving discipline of urodynamics has established itself as a major resource in the diagnosis and therapy of such disturbances.
Stone disease of the urinary tract has always provided a substantial portion of general urologic practice. The recent introduction of rigid and flexible ureteroscopy has greatly improved the capacity of the urologist to deal with the problem while the management of stones in the kidney has been revolutionized twice in the immediate past: First with the introduction of percutaneous methods for stone disintegration and extraction, and secondly by the application of extracorporeal shockwave lithotripsy. Collectively these techniques have largely rendered open surgical procedures for dealing with kidney and ureteral stones obsolete. These new technologies remain under urological stewardship. In addition, advances in the diagnosis and metabolic management of recurrent nephrolithiasis allow urologists to reduce the risk of recurrent stone formation.
Another area of major urologic concern is that of congenital anomalies. The urinary tract is affected by congenital anomalies more than any other organ system. These congenital abnormalities run the gamut from the relatively common problem of cryptorchidism to the complex area of intersexuality. Most urologists do surgically repair many congenital anomalies in children, but the more complex problems are often referred to urologists with specialized training in pediatric urology.
Welcome to New Age Dentistry at AVIS Hospitals!!
Routine dentistry apart, our clinic offers the most advanced and contemporary dental treatment in an ambient atmosphere. This is delivered by a team of highly experienced and overseas trained specialists.
Great way to have a balanced smile by creating a well aligned set of teeth with aesthetic crowns.
With advances in technology, it is possible to customize your crowns and bridges to perfectly suit your pro?le by way of CAD CAM designed prosthesis. This makes sure that you have the best prosthesis in terms of feel,look and longevity.Even better because you can hardly tell the difference between which is real and which is a prosthesis.
By far the best way of replacing teeth. Gone are the days when you have to grind natural teeth to fix bridges. Dental implants give you a tooth for a tooth replacement. Nobody needs to have dentures anymore because you can have a full set of ?xed teeth with implants. Almost a permanent and lifelong solution.
Get your crowded teeth aligned using invisible braces and in selected cases just with aligners which don't require braces to be fixed to teeth
Laser dentistry has today replaced many of the older techniques by delivering painless and bloodless surgeries . Lasers can effectively treat gum infections , sensitivity of teeth, removal of mucosal overgrowths and sometimes can be carried out without even injecting local anesthesia.
To get that beautiful ,everlasting smile , get veneers and laminates attached to your teeth .this will work wonders for spaced teeth, discoloured teeth and teeth affected with ?ourosis.
Get that flashy smile with bright looking teeth with the latest Zoom machine .Just half an hour is what it takes to get your teeth looking whiter!
Jaw deformities and facial asymetry can be treated very effectively with orthognathic surgery where cosmetic and functional rehabilitation of the patient can be carried out with no residual scars on the face. This is indicated for people with overgrown jaws and dental malposition.
Rhinoplasty: Surgical correction of Nose. Blepheroplasty: Correction of eyelids. Face Lift: Procedure to tighten facial tissues to reverse aging changes and give a younger look
Cleft lip, Cleft palate correction. Craniofacial Syndromes Correction.
All EAR/Nose/Throat/Head/Neck problems related surgeries like.
General surgery is a surgical specialty that focuses on abdominal contents including esophagus, stomach, small bowel, colon, liver, pancreas, gallbladder and bile ducts, and often the thyroid gland (depending on local reference patterns
The UC Davis Health System Eye Center’s Vitreo-retinal Service provides highly specialized diagnosis and treatment of complex diseases of the retina, vitreous and macula.
This ophthalmology specialty clinic is equipped with a full range of state-of-the-art technology to provide the most accurate and complete diagnostic information. Such technologies include the use of: