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Dr Nachiket Kaneria — Interventional & Neurointerventional RadiologyDr Nachiket KaneriaInterventional &
Neurointerventional Radiology
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Illustrated patient guide

See how treatment works.

Step-by-step illustrations of image-guided procedures. Each shows simplified anatomy, where the instrument goes, and what the treatment aims to change.

These are educational drawings, not individual treatment plans. The three frames show a mechanism and intended effect, not a guaranteed result. Anatomy, access routes and devices vary.

ArteriesVeinsTreatment or deviceProblem or bile/urine system, as labelled
A clot blocking a brain artery

01A large artery is blocked

A large artery is blockedA temporary stent retriever is removed with the clot. Aspiration is another technique. Emergency imaging determines eligibility; recovery is not guaranteed.ICA: artery entering the brainBrain arteryClot

02A retriever engages the clot

A retriever engages the clotA temporary stent retriever is removed with the clot. Aspiration is another technique. Emergency imaging determines eligibility; recovery is not guaranteed.ICA: artery entering the brainBrain arteryClot

03Aim: restore blood flow

Aim: restore blood flowA temporary stent retriever is removed with the clot. Aspiration is another technique. Emergency imaging determines eligibility; recovery is not guaranteed.ICA: artery entering the brainBrain arteryIntended: reopen the artery
Simplified illustration. A temporary stent retriever is removed with the clot. Aspiration is another technique. Emergency imaging determines eligibility; recovery is not guaranteed.
A bulge in a brain artery

01An aneurysm opens off the artery

An aneurysm opens off the arteryCoils occupy the aneurysm, not the main artery. Follow-up checks whether the aneurysm remains sealed; some cases need further treatment.ICA: artery entering the brainBrain arteryAneurysm

02Coils sit inside the sac

Coils sit inside the sacCoils occupy the aneurysm, not the main artery. Follow-up checks whether the aneurysm remains sealed; some cases need further treatment.ICA: artery entering the brainBrain arteryAneurysm

03Aim: exclude the sac from flow

Aim: exclude the sac from flowCoils occupy the aneurysm, not the main artery. Follow-up checks whether the aneurysm remains sealed; some cases need further treatment.ICA: artery entering the brainBrain arteryAneurysmMain artery stays open
Simplified illustration. Coils occupy the aneurysm, not the main artery. Follow-up checks whether the aneurysm remains sealed; some cases need further treatment.
A tangle of abnormal brain vessels

01Arteries connect through a tangle

Arteries connect through a tangleA brain AVM has a nidus between feeding arteries and draining veins. Embolisation may be staged or combined with surgery or radiosurgery.Abnormal vessel tangleArtery inVein out

02A catheter reaches selected feeders

A catheter reaches selected feedersA brain AVM has a nidus between feeding arteries and draining veins. Embolisation may be staged or combined with surgery or radiosurgery.Abnormal vessel tangleArtery inVein out

03Embolic material closes channels

Embolic material closes channelsA brain AVM has a nidus between feeding arteries and draining veins. Embolisation may be staged or combined with surgery or radiosurgery.Abnormal vessel tangleArtery inVein outSelected abnormal channels treated
Simplified illustration. A brain AVM has a nidus between feeding arteries and draining veins. Embolisation may be staged or combined with surgery or radiosurgery.
A narrowed artery in the neck

01Plaque narrows the carotid

Plaque narrows the carotidThe external carotid has neck branches; the cervical internal carotid does not. A distal filter is one protection approach. Selection also considers medical treatment and surgery.Common carotidInternal carotidExternal carotid

02Balloon and protection device

Balloon and protection deviceThe external carotid has neck branches; the cervical internal carotid does not. A distal filter is one protection approach. Selection also considers medical treatment and surgery.Common carotidInternal carotidExternal carotidProtection filter

03A stent supports the artery

A stent supports the arteryThe external carotid has neck branches; the cervical internal carotid does not. A distal filter is one protection approach. Selection also considers medical treatment and surgery.Common carotidInternal carotidExternal carotidStent across the narrowing
Simplified illustration. The external carotid has neck branches; the cervical internal carotid does not. A distal filter is one protection approach. Selection also considers medical treatment and surgery.
A painful collapsed spinal bone

01A fracture involves the bone

A fracture involves the boneAxial view: the needle passes beside the spinal canal through the bony pedicle. The picture does not imply restoration of vertebral height or certain pain relief.Front of bodyBack of bodyVertebral bodySpinal canal

02Needle enters through a pedicle

Needle enters through a pedicleAxial view: the needle passes beside the spinal canal through the bony pedicle. The picture does not imply restoration of vertebral height or certain pain relief.Front of bodyBack of bodyVertebral bodySpinal canalNeedle

03Cement supports the fractured body

Cement supports the fractured bodyAxial view: the needle passes beside the spinal canal through the bony pedicle. The picture does not imply restoration of vertebral height or certain pain relief.Front of bodyBack of bodyVertebral bodySpinal canalNeedle
Simplified illustration. Axial view: the needle passes beside the spinal canal through the bony pedicle. The picture does not imply restoration of vertebral height or certain pain relief.
Bleeding in the head or neck

01Bleeding arises from a branch

Bleeding arises from a branchSchematic of selective embolisation. The actual vessel and embolic agent depend on imaging and the clinical situation; urgent airway and resuscitation care may also be needed.Head and neck arterial branchSelected branchOther branches remain open

02A catheter reaches the target

A catheter reaches the targetSchematic of selective embolisation. The actual vessel and embolic agent depend on imaging and the clinical situation; urgent airway and resuscitation care may also be needed.Head and neck arterial branchSelected branchOther branches remain open

03Aim: control the bleeding

Aim: control the bleedingSchematic of selective embolisation. The actual vessel and embolic agent depend on imaging and the clinical situation; urgent airway and resuscitation care may also be needed.Head and neck arterial branchSelected branchOther branches remain openAim: reduce flow to the target
Simplified illustration. Schematic of selective embolisation. The actual vessel and embolic agent depend on imaging and the clinical situation; urgent airway and resuscitation care may also be needed.
A tumour with a rich blood supply

01Small arteries feed the tumour

Small arteries feed the tumourThis supports a surgical plan; it does not remove the tumour or guarantee a bloodless operation. Timing is agreed with the surgical team.Artery supplying a vascular tumourSelected branchOther branches remain open

02Selected feeding branches are blocked

Selected feeding branches are blockedThis supports a surgical plan; it does not remove the tumour or guarantee a bloodless operation. Timing is agreed with the surgical team.Artery supplying a vascular tumourSelected branchOther branches remain open

03Aim: reduce operative blood loss

Aim: reduce operative blood lossThis supports a surgical plan; it does not remove the tumour or guarantee a bloodless operation. Timing is agreed with the surgical team.Artery supplying a vascular tumourSelected branchOther branches remain openAim: reduce flow to the target
Simplified illustration. This supports a surgical plan; it does not remove the tumour or guarantee a bloodless operation. Timing is agreed with the surgical team.
Coughing up blood

01An abnormal bronchial branch bleeds

An abnormal bronchial branch bleedsThe lungs, airways and bronchial arteries arising from the systemic circulation are shown. These are distinct from the pulmonary arteries. The underlying lung disease still requires treatment and bleeding can recur.Lungs · front viewAortaBronchial arteriesBleeding site

02A catheter targets that branch

A catheter targets that branchThe lungs, airways and bronchial arteries arising from the systemic circulation are shown. These are distinct from the pulmonary arteries. The underlying lung disease still requires treatment and bleeding can recur.Lungs · front viewAortaBronchial arteriesBleeding site

03Aim: control bleeding

Aim: control bleedingThe lungs, airways and bronchial arteries arising from the systemic circulation are shown. These are distinct from the pulmonary arteries. The underlying lung disease still requires treatment and bleeding can recur.Lungs · front viewAortaBronchial arteriesBleeding site
Simplified illustration. The lungs, airways and bronchial arteries arising from the systemic circulation are shown. These are distinct from the pulmonary arteries. The underlying lung disease still requires treatment and bleeding can recur.
Fluid around a lung

01Fluid lies outside the lung

Fluid lies outside the lungThe drain stays outside lung tissue and above the diaphragm. Expansion can be incomplete, particularly with a trapped lung. Drainage is controlled and monitored.LungPleural fluidDrain stays outside the lung

02A drain enters the pleural space

A drain enters the pleural spaceThe drain stays outside lung tissue and above the diaphragm. Expansion can be incomplete, particularly with a trapped lung. Drainage is controlled and monitored.LungPleural fluidDrain stays outside the lung

03Fluid leaves through the tube

Fluid leaves through the tubeThe drain stays outside lung tissue and above the diaphragm. Expansion can be incomplete, particularly with a trapped lung. Drainage is controlled and monitored.LungPleural fluidDrain stays outside the lung
Simplified illustration. The drain stays outside lung tissue and above the diaphragm. Expansion can be incomplete, particularly with a trapped lung. Drainage is controlled and monitored.
Jaundice from a blocked bile duct

01A blockage prevents bile drainage

A blockage prevents bile drainageThe example shows internal–external drainage into the bowel. An external-only drain is another option. A stent, when used, must span the obstruction.LiverDuct blockageBile ducts inside the liverBowel

02A duct is reached through the liver

A duct is reached through the liverThe example shows internal–external drainage into the bowel. An external-only drain is another option. A stent, when used, must span the obstruction.LiverDuct blockageBile ducts inside the liverBowel

03Drain or stent crosses the blockage

Drain or stent crosses the blockageThe example shows internal–external drainage into the bowel. An external-only drain is another option. A stent, when used, must span the obstruction.LiverDuct blockageBile ducts inside the liverBowel
Simplified illustration. The example shows internal–external drainage into the bowel. An external-only drain is another option. A stent, when used, must span the obstruction.
Bleeding from the stomach or bowel

01A gastric arterial branch bleeds

A gastric arterial branch bleedsThe stomach, small bowel and colon provide context. This example targets a gastric arterial branch; bowel bleeding requires selection of the relevant bowel branch, usually after endoscopic assessment. Preserving bowel blood supply matters; embolisation carries a risk of bowel ischaemia.Stomach & bowel · front viewStomachSmall bowelColonTargeted gastric branch

02The branch is approached by catheter

The branch is approached by catheterThe stomach, small bowel and colon provide context. This example targets a gastric arterial branch; bowel bleeding requires selection of the relevant bowel branch, usually after endoscopic assessment. Preserving bowel blood supply matters; embolisation carries a risk of bowel ischaemia.Stomach & bowel · front viewStomachSmall bowelColonTargeted gastric branch

03Aim: stop the bleeding source

Aim: stop the bleeding sourceThe stomach, small bowel and colon provide context. This example targets a gastric arterial branch; bowel bleeding requires selection of the relevant bowel branch, usually after endoscopic assessment. Preserving bowel blood supply matters; embolisation carries a risk of bowel ischaemia.Stomach & bowel · front viewStomachSmall bowelColonTargeted gastric branch
Simplified illustration. The stomach, small bowel and colon provide context. This example targets a gastric arterial branch; bowel bleeding requires selection of the relevant bowel branch, usually after endoscopic assessment. Preserving bowel blood supply matters; embolisation carries a risk of bowel ischaemia.
High pressure in liver blood vessels

01Portal blood faces high resistance

Portal blood faces high resistanceTIPS connects a portal branch to a hepatic vein through liver tissue, reached through the neck vein. It can worsen confusion or liver/heart function; it is not suitable for everyone.LiverTo heartPortal veinHepatic veinChannel through liver tissue

02Access is through a hepatic vein

Access is through a hepatic veinTIPS connects a portal branch to a hepatic vein through liver tissue, reached through the neck vein. It can worsen confusion or liver/heart function; it is not suitable for everyone.LiverTo heartPortal veinHepatic veinChannel through liver tissue

03A shunt connects portal to hepatic vein

A shunt connects portal to hepatic veinTIPS connects a portal branch to a hepatic vein through liver tissue, reached through the neck vein. It can worsen confusion or liver/heart function; it is not suitable for everyone.LiverTo heartPortal veinHepatic veinChannel through liver tissue
Simplified illustration. TIPS connects a portal branch to a hepatic vein through liver tissue, reached through the neck vein. It can worsen confusion or liver/heart function; it is not suitable for everyone.
A deep collection of pus or fluid

01A collection lies under the skin

A collection lies under the skinThe drain tip stays within the collection. Antibiotics and treatment of the cause may also be needed. Drains can block or need repositioning.Outside the bodyInside the bodySkinCollection

02A catheter enters the collection

A catheter enters the collectionThe drain tip stays within the collection. Antibiotics and treatment of the cause may also be needed. Drains can block or need repositioning.Outside the bodyInside the bodySkinCollectionDrainage bag

03Fluid drains into an external system

Fluid drains into an external systemThe drain tip stays within the collection. Antibiotics and treatment of the cause may also be needed. Drains can block or need repositioning.Outside the bodyInside the bodySkinCollectionDrainage bag
Simplified illustration. The drain tip stays within the collection. Antibiotics and treatment of the cause may also be needed. Drains can block or need repositioning.
A dialysis fistula with poor flow

01An outflow narrowing limits access

An outflow narrowing limits accessThe artery continues beyond the surgical join; the arterialised vein returns blood to the heart. A clotted access may need clot removal as well, and repeat narrowing can occur.Artery: continues to the handVein: returns to heartSurgical join

02A balloon treats the narrowing

A balloon treats the narrowingThe artery continues beyond the surgical join; the arterialised vein returns blood to the heart. A clotted access may need clot removal as well, and repeat narrowing can occur.Artery: continues to the handVein: returns to heartSurgical join

03Aim: improve access flow

Aim: improve access flowThe artery continues beyond the surgical join; the arterialised vein returns blood to the heart. A clotted access may need clot removal as well, and repeat narrowing can occur.Artery: continues to the handVein: returns to heartSurgical join
Simplified illustration. The artery continues beyond the surgical join; the arterialised vein returns blood to the heart. A clotted access may need clot removal as well, and repeat narrowing can occur.
Dialysis without a working fistula

01A neck vein reaches the central veins

A neck vein reaches the central veinsA tunnelled dialysis catheter has a cuff in the skin tunnel; its tip position is checked for the device used. It does not replace the need for an access plan.Right atriumJugular veinCentral vein

02The tube passes through a skin tunnel

The tube passes through a skin tunnelA tunnelled dialysis catheter has a cuff in the skin tunnel; its tip position is checked for the device used. It does not replace the need for an access plan.Right atriumJugular veinCentral veinCuff in the skin tunnel

03Dialysis uses the external limbs

Dialysis uses the external limbsA tunnelled dialysis catheter has a cuff in the skin tunnel; its tip position is checked for the device used. It does not replace the need for an access plan.Right atriumJugular veinCentral veinCuff in the skin tunnel
Simplified illustration. A tunnelled dialysis catheter has a cuff in the skin tunnel; its tip position is checked for the device used. It does not replace the need for an access plan.
A kidney whose drainage is blocked

01Urine collects above an obstruction

Urine collects above an obstructionThe drain reaches a calyx and collecting system through kidney tissue; it does not remove the ureteric obstruction. The original blockage still needs a treatment plan.Ureter blockageKidney tissueCollecting systemDrain to an external bag

02A drain enters the collecting system

A drain enters the collecting systemThe drain reaches a calyx and collecting system through kidney tissue; it does not remove the ureteric obstruction. The original blockage still needs a treatment plan.Ureter blockageKidney tissueCollecting systemDrain to an external bag

03Urine can leave to an external bag

Urine can leave to an external bagThe drain reaches a calyx and collecting system through kidney tissue; it does not remove the ureteric obstruction. The original blockage still needs a treatment plan.Ureter blockageKidney tissueCollecting systemDrain to an external bag
Simplified illustration. The drain reaches a calyx and collecting system through kidney tissue; it does not remove the ureteric obstruction. The original blockage still needs a treatment plan.
Heavy periods associated with fibroids

01A fibroid lies in the uterine wall

A fibroid lies in the uterine wallThis example targets the artery supplying the pictured fibroid; the other side is left untreated in this drawing. Actual treatment follows the vascular supply and often involves both uterine arteries. Pregnancy plans need separate discussion.Uterus: front viewUterine arteries on both sidesFibroid

02Particles enter the supplying artery

Particles enter the supplying arteryThis example targets the artery supplying the pictured fibroid; the other side is left untreated in this drawing. Actual treatment follows the vascular supply and often involves both uterine arteries. Pregnancy plans need separate discussion.Uterus: front viewUterine arteries on both sidesFibroid

03Aim: reduce fibroid blood supply

Aim: reduce fibroid blood supplyThis example targets the artery supplying the pictured fibroid; the other side is left untreated in this drawing. Actual treatment follows the vascular supply and often involves both uterine arteries. Pregnancy plans need separate discussion.Uterus: front viewUterine arteries on both sidesFibroid
Simplified illustration. This example targets the artery supplying the pictured fibroid; the other side is left untreated in this drawing. Actual treatment follows the vascular supply and often involves both uterine arteries. Pregnancy plans need separate discussion.
Urinary symptoms from an enlarged prostate

01The gland surrounds the urethra

The gland surrounds the urethraThe prostate sits below the bladder. Its arteries and connections to nearby organs vary; urinary improvement is not immediate or guaranteed. Urological assessment is required.BladderUrethraProstate

02Particles enter prostatic branches

Particles enter prostatic branchesThe prostate sits below the bladder. Its arteries and connections to nearby organs vary; urinary improvement is not immediate or guaranteed. Urological assessment is required.BladderUrethraProstate

03Aim: gradual reduction in gland size

Aim: gradual reduction in gland sizeThe prostate sits below the bladder. Its arteries and connections to nearby organs vary; urinary improvement is not immediate or guaranteed. Urological assessment is required.BladderUrethraProstate
Simplified illustration. The prostate sits below the bladder. Its arteries and connections to nearby organs vary; urinary improvement is not immediate or guaranteed. Urological assessment is required.
Heavy bleeding after childbirth

01The uterine bed is bleeding

The uterine bed is bleedingThis is an emergency adjunct to resuscitation and obstetric treatment. It must not delay life-saving surgery, and preservation of the uterus cannot be guaranteed.Uterus: front viewUterine arteries on both sidesUterine bleeding

02Uterine arteries may be embolised

Uterine arteries may be embolisedThis is an emergency adjunct to resuscitation and obstetric treatment. It must not delay life-saving surgery, and preservation of the uterus cannot be guaranteed.Uterus: front viewUterine arteries on both sidesUterine bleeding

03Aim: help control haemorrhage

Aim: help control haemorrhageThis is an emergency adjunct to resuscitation and obstetric treatment. It must not delay life-saving surgery, and preservation of the uterus cannot be guaranteed.Uterus: front viewUterine arteries on both sidesUterine bleeding
Simplified illustration. This is an emergency adjunct to resuscitation and obstetric treatment. It must not delay life-saving surgery, and preservation of the uterus cannot be guaranteed.
Enlarged veins around a testicle

01Reflux enters the gonadal vein

Reflux enters the gonadal veinLeft-sided anatomy: the gonadal vein drains to the left renal vein. Alternative pathways drain the testicle. Symptoms or fertility may not improve; other causes need evaluation.Left renal veinVena cavaGonadal veinLeft-sided example

02The refluxing vein is embolised

The refluxing vein is embolisedLeft-sided anatomy: the gonadal vein drains to the left renal vein. Alternative pathways drain the testicle. Symptoms or fertility may not improve; other causes need evaluation.Left renal veinVena cavaGonadal veinLeft-sided example

03Aim: reduce backward flow

Aim: reduce backward flowLeft-sided anatomy: the gonadal vein drains to the left renal vein. Alternative pathways drain the testicle. Symptoms or fertility may not improve; other causes need evaluation.Left renal veinVena cavaGonadal veinLeft-sided example
Simplified illustration. Left-sided anatomy: the gonadal vein drains to the left renal vein. Alternative pathways drain the testicle. Symptoms or fertility may not improve; other causes need evaluation.
Pelvic symptoms linked to abnormal veins

01Reflux reaches pelvic veins

Reflux reaches pelvic veinsThis is a left ovarian-vein example, not a testicular diagram. Dilated veins alone do not establish the cause of pelvic pain; other causes require assessment.Left renal veinVena cavaGonadal veinLeft-sided example

02A selected gonadal vein is treated

A selected gonadal vein is treatedThis is a left ovarian-vein example, not a testicular diagram. Dilated veins alone do not establish the cause of pelvic pain; other causes require assessment.Left renal veinVena cavaGonadal veinLeft-sided example

03Aim: reduce abnormal venous flow

Aim: reduce abnormal venous flowThis is a left ovarian-vein example, not a testicular diagram. Dilated veins alone do not establish the cause of pelvic pain; other causes require assessment.Left renal veinVena cavaGonadal veinLeft-sided example
Simplified illustration. This is a left ovarian-vein example, not a testicular diagram. Dilated veins alone do not establish the cause of pelvic pain; other causes require assessment.
Leg pain from narrowed arteries

01Plaque restricts the artery

Plaque restricts the arteryThe balloon and stent sit inside the artery. A stent is not needed in every case. Exercise, risk-factor treatment, medicines and sometimes bypass surgery remain important.Magnified leg arteryToward the foot →Artery wall

02A balloon expands the narrowing

A balloon expands the narrowingThe balloon and stent sit inside the artery. A stent is not needed in every case. Exercise, risk-factor treatment, medicines and sometimes bypass surgery remain important.Magnified leg arteryToward the foot →Artery wall

03A stent may support the lumen

A stent may support the lumenThe balloon and stent sit inside the artery. A stent is not needed in every case. Exercise, risk-factor treatment, medicines and sometimes bypass surgery remain important.Magnified leg arteryToward the foot →Artery wall
Simplified illustration. The balloon and stent sit inside the artery. A stent is not needed in every case. Exercise, risk-factor treatment, medicines and sometimes bypass surgery remain important.
A superficial leg vein with reflux

01Blood flows backward in a surface vein

Blood flows backward in a surface veinThe great saphenous vein joins a deep vein; the deep vein stays open. This laser example leaves the junction protected. Branch treatment and follow-up may also be required.Deep veinSuperficial vein

02A fibre treats the selected segment

A fibre treats the selected segmentThe great saphenous vein joins a deep vein; the deep vein stays open. This laser example leaves the junction protected. Branch treatment and follow-up may also be required.Deep veinSuperficial veinFibre withdrawn during treatment

03Deep veins continue returning blood

Deep veins continue returning bloodThe great saphenous vein joins a deep vein; the deep vein stays open. This laser example leaves the junction protected. Branch treatment and follow-up may also be required.Deep veinSuperficial vein
Simplified illustration. The great saphenous vein joins a deep vein; the deep vein stays open. This laser example leaves the junction protected. Branch treatment and follow-up may also be required.
A clot in a deep leg vein

01Clot obstructs the vein

Clot obstructs the veinAnticoagulation is the usual treatment for DVT. Catheter treatment is reserved for selected cases; a stent is considered only for an appropriate residual narrowing.Deep leg vein: enlarged detailBlood returns toward the heart →

02Selected cases receive catheter therapy

Selected cases receive catheter therapyAnticoagulation is the usual treatment for DVT. Catheter treatment is reserved for selected cases; a stent is considered only for an appropriate residual narrowing.Deep leg vein: enlarged detailBlood returns toward the heart →

03Aim: reduce the clot burden

Aim: reduce the clot burdenAnticoagulation is the usual treatment for DVT. Catheter treatment is reserved for selected cases; a stent is considered only for an appropriate residual narrowing.Deep leg vein: enlarged detailBlood returns toward the heart →
Simplified illustration. Anticoagulation is the usual treatment for DVT. Catheter treatment is reserved for selected cases; a stent is considered only for an appropriate residual narrowing.
A filter for selected clot-related risks

01Clot can travel toward the lungs

Clot can travel toward the lungsA typical conical filter points toward the heart and sits below renal-vein entry. It does not dissolve leg clots or remove all embolic risk. Retrieval planning is important.Toward heartRenal veinsBelow renal veins

02A filter is placed below renal veins

A filter is placed below renal veinsA typical conical filter points toward the heart and sits below renal-vein entry. It does not dissolve leg clots or remove all embolic risk. Retrieval planning is important.Toward heartRenal veinsBelow renal veins

03The filter may intercept travelling clot

The filter may intercept travelling clotA typical conical filter points toward the heart and sits below renal-vein entry. It does not dissolve leg clots or remove all embolic risk. Retrieval planning is important.Toward heartRenal veinsBelow renal veins
Simplified illustration. A typical conical filter points toward the heart and sits below renal-vein entry. It does not dissolve leg clots or remove all embolic risk. Retrieval planning is important.
Treating a liver tumour through its artery

01An artery supplies the tumour

An artery supplies the tumourThe hepatic artery is distinct from the portal vein. Chemoembolisation is selected by tumour type, stage and liver function; some drug can reach the wider circulation.LiverHepatic arteryTumour

02Drug and embolic material reach it

Drug and embolic material reach itThe hepatic artery is distinct from the portal vein. Chemoembolisation is selected by tumour type, stage and liver function; some drug can reach the wider circulation.LiverHepatic arteryTumour

03Aim: treat the selected tumour area

Aim: treat the selected tumour areaThe hepatic artery is distinct from the portal vein. Chemoembolisation is selected by tumour type, stage and liver function; some drug can reach the wider circulation.LiverHepatic arteryTumour
Simplified illustration. The hepatic artery is distinct from the portal vein. Chemoembolisation is selected by tumour type, stage and liver function; some drug can reach the wider circulation.
Treating a small liver tumour with heat

01A tumour is identified on imaging

A tumour is identified on imagingThe planned zone extends beyond the visible tumour when safe. Nearby vessels, bile ducts and other organs affect suitability. Follow-up imaging checks the actual response.LiverSkinTumour

02A probe is guided into the target

A probe is guided into the targetThe planned zone extends beyond the visible tumour when safe. Nearby vessels, bile ducts and other organs affect suitability. Follow-up imaging checks the actual response.LiverSkinTumour

03A treatment zone includes a margin

A treatment zone includes a marginThe planned zone extends beyond the visible tumour when safe. Nearby vessels, bile ducts and other organs affect suitability. Follow-up imaging checks the actual response.LiverSkinTreatment zone + marginTumour
Simplified illustration. The planned zone extends beyond the visible tumour when safe. Nearby vessels, bile ducts and other organs affect suitability. Follow-up imaging checks the actual response.
Biopsy: a tissue sample from an organ

01A target is selected on imaging

A target is selected on imagingOne image-guided biopsy approach is illustrated using a liver lesion. Biopsy may sample lung, kidney, liver or other tissue; the route and target differ by organ. Kidney biopsy usually targets cortex, not the urine collecting system. Sampling does not remove the lesion or guarantee a diagnosis; repeat sampling may be needed.SkinLiverSample site

02A needle samples the target

A needle samples the targetOne image-guided biopsy approach is illustrated using a liver lesion. Biopsy may sample lung, kidney, liver or other tissue; the route and target differ by organ. Kidney biopsy usually targets cortex, not the urine collecting system. Sampling does not remove the lesion or guarantee a diagnosis; repeat sampling may be needed.SkinLiverSample site

03The laboratory analyses the sample

The laboratory analyses the sampleOne image-guided biopsy approach is illustrated using a liver lesion. Biopsy may sample lung, kidney, liver or other tissue; the route and target differ by organ. Kidney biopsy usually targets cortex, not the urine collecting system. Sampling does not remove the lesion or guarantee a diagnosis; repeat sampling may be needed.SkinLiverTissue sampleSample site
Simplified illustration. One image-guided biopsy approach is illustrated using a liver lesion. Biopsy may sample lung, kidney, liver or other tissue; the route and target differ by organ. Kidney biopsy usually targets cortex, not the urine collecting system. Sampling does not remove the lesion or guarantee a diagnosis; repeat sampling may be needed.
Repeated access for cancer medicines

01A central vein provides access

A central vein provides accessThe catheter enters a vein and follows it to the central circulation. The port stays under the skin and is accessed with a suitable non-coring needle.Right atriumJugular veinCentral vein

02A reservoir sits beneath the skin

A reservoir sits beneath the skinThe catheter enters a vein and follows it to the central circulation. The port stays under the skin and is accessed with a suitable non-coring needle.Right atriumJugular veinCentral veinPort under skin

03A needle accesses the reservoir

A needle accesses the reservoirThe catheter enters a vein and follows it to the central circulation. The port stays under the skin and is accessed with a suitable non-coring needle.Right atriumJugular veinCentral veinPort under skin
Simplified illustration. The catheter enters a vein and follows it to the central circulation. The port stays under the skin and is accessed with a suitable non-coring needle.
Preparing the liver for planned surgery

01The future remnant may be too small

The future remnant may be too smallConnected portal branches supply both sides. The branches to the side planned for removal are blocked; the future remnant remains perfused. Growth must be measured before deciding on surgery.LiverPatient’s rightPatient’s leftSide planned for surgeryRemnant to be preserved

02Portal branches on the resection side close

Portal branches on the resection side closeConnected portal branches supply both sides. The branches to the side planned for removal are blocked; the future remnant remains perfused. Growth must be measured before deciding on surgery.LiverPatient’s rightPatient’s leftSide planned for surgeryRemnant to be preserved

03Aim: growth of the preserved side

Aim: growth of the preserved sideConnected portal branches supply both sides. The branches to the side planned for removal are blocked; the future remnant remains perfused. Growth must be measured before deciding on surgery.LiverPatient’s rightPatient’s leftSide planned for surgeryRemnant to be preserved
Simplified illustration. Connected portal branches supply both sides. The branches to the side planned for removal are blocked; the future remnant remains perfused. Growth must be measured before deciding on surgery.
Another way to treat selected brain aneurysms

01Aneurysm opens from the parent artery

Aneurysm opens from the parent arteryA flow diverter sits in the parent artery, not inside the sac. Aneurysm closure develops over time; antiplatelet treatment and follow-up are essential parts of selection and care.ICA: artery entering the brainBrain arteryAneurysm

02A mesh device spans the neck

A mesh device spans the neckA flow diverter sits in the parent artery, not inside the sac. Aneurysm closure develops over time; antiplatelet treatment and follow-up are essential parts of selection and care.ICA: artery entering the brainBrain arteryAneurysm

03Aim: redirect flow along the artery

Aim: redirect flow along the arteryA flow diverter sits in the parent artery, not inside the sac. Aneurysm closure develops over time; antiplatelet treatment and follow-up are essential parts of selection and care.ICA: artery entering the brainBrain arteryAneurysmMain artery stays open
Simplified illustration. A flow diverter sits in the parent artery, not inside the sac. Aneurysm closure develops over time; antiplatelet treatment and follow-up are essential parts of selection and care.
An abnormal connection in the brain covering

01A dural artery connects to a vein

A dural artery connects to a veinA dural fistula is a direct connection without the nidus of a brain AVM. The venous drainage pattern determines risk and the treatment route.Dural venous sinusDirect artery–vein connectionArtery inVein out

02A catheter targets the connection

A catheter targets the connectionA dural fistula is a direct connection without the nidus of a brain AVM. The venous drainage pattern determines risk and the treatment route.Dural venous sinusDirect artery–vein connectionArtery inVein out

03Aim: close the abnormal shunt

Aim: close the abnormal shuntA dural fistula is a direct connection without the nidus of a brain AVM. The venous drainage pattern determines risk and the treatment route.Dural venous sinusDirect artery–vein connectionArtery inVein outSelected abnormal channels treated
Simplified illustration. A dural fistula is a direct connection without the nidus of a brain AVM. The venous drainage pattern determines risk and the treatment route.
An abnormal connection behind the eye

01An artery opens into a venous space

An artery opens into a venous spaceA carotid-cavernous fistula involves the cavernous sinus; backward flow may enlarge eye veins. Arterial or venous routes can be used, depending on the type.EyeInternal carotidArtery to brainCavernous sinus

02The shunt is targeted from within vessels

The shunt is targeted from within vesselsA carotid-cavernous fistula involves the cavernous sinus; backward flow may enlarge eye veins. Arterial or venous routes can be used, depending on the type.EyeInternal carotidArtery to brainCavernous sinus

03Aim: remove abnormal venous pressure

Aim: remove abnormal venous pressureA carotid-cavernous fistula involves the cavernous sinus; backward flow may enlarge eye veins. Arterial or venous routes can be used, depending on the type.EyeInternal carotidArtery to brainCavernous sinus
Simplified illustration. A carotid-cavernous fistula involves the cavernous sinus; backward flow may enlarge eye veins. Arterial or venous routes can be used, depending on the type.
Understanding the blood vessels of the brain

01A catheter is placed in an artery

A catheter is placed in an arteryCerebral angiography is an invasive vessel study using contrast and X-rays. It can guide treatment planning but has risks including vascular injury and stroke.ICA: artery entering the brainBrain artery

02Contrast outlines the branches

Contrast outlines the branchesCerebral angiography is an invasive vessel study using contrast and X-rays. It can guide treatment planning but has risks including vascular injury and stroke.ICA: artery entering the brainBrain artery

03Images guide diagnosis and planning

Images guide diagnosis and planningCerebral angiography is an invasive vessel study using contrast and X-rays. It can guide treatment planning but has risks including vascular injury and stroke.ICA: artery entering the brainBrain arteryImages show vessel detail
Simplified illustration. Cerebral angiography is an invasive vessel study using contrast and X-rays. It can guide treatment planning but has risks including vascular injury and stroke.
A solid benign thyroid nodule

01The nodule lies within the thyroid

The nodule lies within the thyroidCross-sectional schematic: front of the neck is at the top. The antenna crosses the skin and isthmus towards the target, above the trachea. Real ultrasound imaging determines a safe route and protection of nerves, vessels and surrounding structures. Shrinkage is assessed later; this is not an immediate or guaranteed result.Skin; front of neckTracheaThyroidNodule

02An antenna heats selected nodule tissue

An antenna heats selected nodule tissueCross-sectional schematic: front of the neck is at the top. The antenna crosses the skin and isthmus towards the target, above the trachea. Real ultrasound imaging determines a safe route and protection of nerves, vessels and surrounding structures. Shrinkage is assessed later; this is not an immediate or guaranteed result.Skin; front of neckTracheaThyroidAntennaNodule

03Aim: gradual reduction in the nodule

Aim: gradual reduction in the noduleCross-sectional schematic: front of the neck is at the top. The antenna crosses the skin and isthmus towards the target, above the trachea. Real ultrasound imaging determines a safe route and protection of nerves, vessels and surrounding structures. Shrinkage is assessed later; this is not an immediate or guaranteed result.Skin; front of neckTracheaThyroidNoduleLater follow-up
Simplified illustration. Cross-sectional schematic: front of the neck is at the top. The antenna crosses the skin and isthmus towards the target, above the trachea. Real ultrasound imaging determines a safe route and protection of nerves, vessels and surrounding structures. Shrinkage is assessed later; this is not an immediate or guaranteed result.
A fluid-filled thyroid cyst

01A benign cyst contains fluid

A benign cyst contains fluidAfter appropriate assessment, a fine needle drains a selected cyst and medical ethanol treats its lining. This schematic omits equipment and does not show procedural steps or volumes. The needle stays within the cyst for treatment; leakage can injure nearby structures. Cysts can recur.Skin; front of neckTracheaThyroidCyst

02Drainage and ethanol treatment

Drainage and ethanol treatmentAfter appropriate assessment, a fine needle drains a selected cyst and medical ethanol treats its lining. This schematic omits equipment and does not show procedural steps or volumes. The needle stays within the cyst for treatment; leakage can injure nearby structures. Cysts can recur.Skin; front of neckTracheaThyroidFine needleCyst

03Aim: reduce fluid re-accumulation

Aim: reduce fluid re-accumulationAfter appropriate assessment, a fine needle drains a selected cyst and medical ethanol treats its lining. This schematic omits equipment and does not show procedural steps or volumes. The needle stays within the cyst for treatment; leakage can injure nearby structures. Cysts can recur.Skin; front of neckTracheaThyroidCystLater follow-up
Simplified illustration. After appropriate assessment, a fine needle drains a selected cyst and medical ethanol treats its lining. This schematic omits equipment and does not show procedural steps or volumes. The needle stays within the cyst for treatment; leakage can injure nearby structures. Cysts can recur.
A thyroid nodule approached through its artery

01A thyroid arterial branch supplies tissue

A thyroid arterial branch supplies tissueOne selected arterial branch is shown, not the complete thyroid blood supply. The catheter and particles remain in the arterial route; this is different from putting an ablation needle into a nodule. Actual vessel selection and the extent treated depend on angiography. Non-target embolisation can cause serious injury.Skin; front of neckTracheaThyroidThyroid arteryNodule

02A catheter reaches a selected branch

A catheter reaches a selected branchOne selected arterial branch is shown, not the complete thyroid blood supply. The catheter and particles remain in the arterial route; this is different from putting an ablation needle into a nodule. Actual vessel selection and the extent treated depend on angiography. Non-target embolisation can cause serious injury.Skin; front of neckTracheaThyroidThyroid arteryCatheter stays within arteryNodule

03Aim: gradual reduction of treated tissue

Aim: gradual reduction of treated tissueOne selected arterial branch is shown, not the complete thyroid blood supply. The catheter and particles remain in the arterial route; this is different from putting an ablation needle into a nodule. Actual vessel selection and the extent treated depend on angiography. Non-target embolisation can cause serious injury.Skin; front of neckTracheaThyroidThyroid arteryNoduleLater follow-up
Simplified illustration. One selected arterial branch is shown, not the complete thyroid blood supply. The catheter and particles remain in the arterial route; this is different from putting an ablation needle into a nodule. Actual vessel selection and the extent treated depend on angiography. Non-target embolisation can cause serious injury.
Heating selected fibroid tissue

01A fibroid lies in the uterine wall

A fibroid lies in the uterine wallThe fibroid is targeted directly; the uterine lining is not the ablation target. This simplified access route omits nearby bowel, bladder and other structures that must be assessed on real imaging. Actual access varies. Microwave fibroid ablation is being introduced at this practice with proctor support; prior fibroid-ablation cases are not claimed. Pregnancy plans require separate discussion.Skin; schematic accessUterusFibroidTarget is fibroid tissue, not the lining

02A microwave antenna enters the target

A microwave antenna enters the targetThe fibroid is targeted directly; the uterine lining is not the ablation target. This simplified access route omits nearby bowel, bladder and other structures that must be assessed on real imaging. Actual access varies. Microwave fibroid ablation is being introduced at this practice with proctor support; prior fibroid-ablation cases are not claimed. Pregnancy plans require separate discussion.Skin; schematic accessUterusFibroidTarget is fibroid tissue, not the lining

03Aim: gradual shrinkage of treated tissue

Aim: gradual shrinkage of treated tissueThe fibroid is targeted directly; the uterine lining is not the ablation target. This simplified access route omits nearby bowel, bladder and other structures that must be assessed on real imaging. Actual access varies. Microwave fibroid ablation is being introduced at this practice with proctor support; prior fibroid-ablation cases are not claimed. Pregnancy plans require separate discussion.Skin; schematic accessUterusFibroidTarget is fibroid tissue, not the lining
Simplified illustration. The fibroid is targeted directly; the uterine lining is not the ablation target. This simplified access route omits nearby bowel, bladder and other structures that must be assessed on real imaging. Actual access varies. Microwave fibroid ablation is being introduced at this practice with proctor support; prior fibroid-ablation cases are not claimed. Pregnancy plans require separate discussion.

Background references: ACR/RSNA: intracranial vascular treatments; TIPS; IVC filters.