#angiography cost

[hms-desk]

Understanding Angioplasty: A Step-by-Step Journey from Blockage to Recovery

Angioplasty, a medical marvel of modern science, is a procedure that opens blocked or narrowed arteries, restoring blood flow to the heart muscle. If you or someone you know is preparing for this intervention, understanding the journey from pre-procedure preparation to post-procedure recovery can alleviate fears and uncertainties.

Join us as we embark on a comprehensive exploration of the angioplasty procedure, step by step.

Preparation: The Journey Begins Before the procedure commences, thorough preparation is key. Patients typically undergo a series of pre-procedural evaluations, including blood tests, electrocardiograms (ECG), and possibly imaging scans like angiograms. These assessments provide valuable insights into the condition of the arteries and guide the medical team in planning the intervention.

Arrival at the Hospital: Setting the Stage On the day of the procedure, patients arrive at the hospital and are greeted by a team of skilled medical professionals dedicated to their care. After completing necessary paperwork and consenting to the procedure, patients are prepped for the angioplasty in a designated pre-operative area. Here, they receive instructions, have vital signs monitored, and are prepped for anesthesia administration.

Anesthesia: Drifting into Comfort Once in the angiography suite, patients are administered local anesthesia to numb the area where the catheter will be inserted. In some cases, mild sedation may also be provided to help patients relax during the procedure. While fully conscious, patients typically feel minimal discomfort or pain due to the anesthesia.

Catheter Insertion: Navigating the Arterial Pathway With the patient comfortably positioned, the interventional cardiologist begins the procedure by inserting a thin, flexible tube called a catheter into a blood vessel, usually in the groin or wrist. Guided by fluoroscopy, a type of real-time X-ray imaging, the catheter is carefully threaded through the arterial pathway until it reaches the blocked or narrowed area of the coronary artery.

Angiography: Visualizing the Blockage Once the catheter is in position, contrast dye is injected through the catheter, allowing the cardiologist to visualize the arterial anatomy and pinpoint the location and severity of the blockage. This angiographic imaging provides crucial information for planning the subsequent steps of the procedure.

Balloon Inflation: Opening the Artery With the blockage identified, the next step involves inflating a tiny balloon at the tip of the catheter within the narrowed artery. This balloon inflation compresses the plaque against the arterial walls, widening the artery and restoring blood flow to the heart muscle. The duration and pressure of balloon inflation are carefully controlled to achieve optimal results.

Stent Placement: Scaffolding for Support In some cases, a metal mesh tube called a stent is inserted into the newly widened artery to provide structural support and prevent re-narrowing, known as restenosis. The stent is expanded using balloon inflation and remains permanently in place, keeping the artery open and ensuring long-term blood flow.

Recovery: Restoring Health and Vitality Following the procedure, patients are closely monitored in a recovery area for a few hours to ensure stability and assess for any complications. Once deemed safe, patients are discharged with instructions for post-procedural care and follow-up appointments.

Angioplasty is a transformative procedure that restores blood flow to the heart, alleviating symptoms and improving quality of life for countless individuals worldwide. By understanding the step-by-step journey of angioplasty, patients and their loved ones can approach the procedure with confidence and optimism, knowing they are in capable hands every step of the way.

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[drrajivagarwal2]

Best Coronary Angiography Doctor in Delhi

Angiography treatment is a diagnostic procedure that uses X-rays to visualize blood vessels in the body. Dr. Rajiv Agarwal, the Best Coronary Angiography Doctor in Delhi, specializes in top-notch Coronary Angiography Treatment. With over 30 years of experience, he offers exceptional care to patients at Max Smart Super Speciality Hospital, Saket, New Delhi.

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[protectyourheath]

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[hridayicaclinic12]

Coronary Angiography Treatment in Delhi

Coronary angiography is a diagnostic test that is used to evaluate the health of the heart and the blood vessels surrounding it. If you are experiencing chest pain, shortness of breath, or other symptoms that could be related to heart disease, then it is important to seek out the help of a qualified medical professional. One such doctor who specializes in coronary angiography is Dr. Vivek Kumar. He is widely recognized as one of the best coronary angiography doctors in Delhi. He is a highly skilled and experienced physician who has treated countless patients over the years. As one of the top coronary angiography doctors in Delhi, Dr. Vivek Kumar provides a wide range of services related to this important diagnostic procedure. He uses state-of-the-art equipment and technology to perform coronary angiography, and he works closely with his patients to ensure that they are comfortable and well-informed throughout the process. He has an immense experience of 12+ years and presently working at Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi. If you are looking for coronary angiography doctors in Delhi NCR, then Dr. Vivek Kumar is an excellent choice. He has a deep understanding of the human heart and the vascular system, and he can provide you Coronary Angiography Treatment in Delhi at minimal charges. Contact his office today to learn more about his services and to schedule an appointment.

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[superspecialitycare0]

Angiography in India, Cost of Angiography in India

Angiography in India is a minimally invasive diagnostic procedure used to evaluate the blood vessels for blockages or narrowing. It is a safe and effective procedure with a very high success rate.

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[credihealthin]

Angiography Cost in India - Credihealth

Are you looking for the Angiography cost in India? Credihealth is a healthcare source that provides Angiography procedures and treatment to patients at affordable prices in India. We are at the No. 1 position as a health services provider across the world. Book your appointment now with Credihealth.

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[sonalsharma28]

The Average Price of Spine Surgery Cost in Chennai. Top Hospitals allows you to research the cost of your surgery, a list of your potential providers, and patient reviews. Credihealth allows you to shop around for the best price on spine surgery in Mumbai and schedule your procedure at your convenience.

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[lakshkapoor11]

Angiography Cost In India Starts From INR 14,430 Consult Leading Interventional Cardiologist For Affordable Angiography Through Vaidam Health.

#Angiography Cost In India

[lupinepublishers]

Lupine Publishers|Radiology; USG and Colour Doppler of Post Renal Transplant Complications

Abstract

Kidney transplant is the treatment of choice for patients with end-stage renal disease. Kidney transplant offers better quality of life. It is more cost effective than hemodialysis. Advances in surgical technique, along with improvement in organ preservation and immunosuppression have improved patient outcomes. Post-operative complications, however, can limit this success. Ultrasound and Doppler study is the primary imaging modality for evaluation of renal transplant, providing real –time information about complication in graft. A multimodality approach including CT scan, MRI or conventional angiography may be necessary in cases when sonography and Doppler are inconclusive to diagnose the etiologies of these complications. Radiologists play an integral role within the multidisciplinary team in care of transplant patient at every stage of the transplant process. Therefore, the radiologist should always be aware when evaluating the failing renal graft, whether the cause is renal or extrinsic. In this pictorial essay we tried to gather the most common complication of transplant kidney in different cases that occurred in our hospital, with an emphasis on Ultrasound and Doppler study.

Keywords: USG; Colour Doppler; Post renal transplantation; Complications

Introduction

The preferred modality for renal replacement is renal transplantation, and its superiority in prolonging the longevity of patients with end-stage renal disease is well established [1]. Kidney transplantation is typically classified as deceased-donor (formerly known as cadaveric) or living-donor transplantation depending on the source of the donor organ. Due to improvement in transplantation technology, advancement in immunosuppressant and graft preservation techniques the 1-year survival rates for grafts, are reported to be 80% for mismatched cadaveric renal grafts; 90% for nonidentical living related grafts; 95% for human lymphocyte antigen-identical grafts [2]. Radiologists play a major role at every stage of the transplant process with transplantation team. Ultrasonography with colour Doppler is the principal modality used for evaluation of renal allograft. USG is a relatively cheap, noninvasive, and non-nephrotoxic modality. It is applied for diagnostic and monitoring purposes in the post-transplant period. This pictorial essay describes USG and Doppler imaging appearances of the major complications that may occur in renal transplantation. All our images have been obtained from a single our center which is major transplantation center in India. All post renal transplant patients undergo a USG and comprehensive Doppler evaluation on post-operative day one. The sonographic examination algorithm includes gray-scale evaluation of the graft and spectral Doppler. Further imaging is based on clinical follow-up including daily monitoring of laboratory values. If clinical parameters are abnormal, repeat sonography is performed and depending on the results, CT, MRI, or angiography may be requested.

Surgical Technique

Surgical technique and location of placement of renal allograft depends on the variation in arterial and venous anatomy of donor. The transplanted kidney is usually placed extraperitoneally in the patient’s right iliac fossa (less commonly in left iliac fossa), with end-to-side or end to end anastomosis to the external iliac vasculature. The currently preferred method for restoring urinary drainage is ureteroneocystostomy, a procedure by which the ureter is implanted directly into the dome of the bladder (Figure 1).

Figure 1: Diagrammatic representation of anatomical and anastomotic arrangement (end to side fashion) in renal transplantation in right renal fossa

Post renal transplantation complications

Urologic Complications

The prevalence of urologic complications varied from 10% to 25% with a mortality rate ranging from 20% to 30%. Incidence rate is decreased range between 3% and 9% in the current era because of advancement in surgical techniques and frequent use of ureteral stents [3,4].

Urinary Obstruction

a) Incidence: 2%-5% of kidney transplant recipients. b) Site of obstruction: Approx. 90% of stenoses occur in the distal third of the ureter due to its poor vascular supply. c) Imaging appearance: US can easily confirm the diagnosis of hydronephrosis and dilated renal pelvis and thus determine the level of ureteral obstruction (Figure 2). When contents of pelvic calyceal system are echogenic and weakly shadowing, fungus balls should be considered, whereas low-level echoes suggest pyonephrosis (Figure 3).

Figure 2: Grey scale USG image shows (A) dilated pelvic calyceal system, (B) dilated ureter may favors urinary obstruction.

Figure 3: Grey scale USG image shows echogenic material within (A) dilated pelvic calyceal system, (B) dilated renal pelvis may favors debris.

Urine Leaks and Urinomas

a) Incidence: up to 6 % of renal transplant recipients [5] b) Location: extraperitoneal or intraperitoneal, if intraperitoneal may present with ascites. c) Imaging appearance: USG findings are nonspecific, well defined anechoic fluid collection with septa or without septation, adjacent to the lower pole of the transplant in most of the cases (Figure 4).

Figure 4: Grey scale USG image shows anechoic collection (A) near urinary bladder, (B) near lower pole of transplanted kidney may favors urinoma.

Drainage of fluid under ultrasound guidance and testing the fluid for creatinine helps to differentiate it from seromas or lymphoceles. High concentration of creatinine will be found in case of urinoma if we compare with serous fluid.

Calculous Disease

a) Incidence: 1% to 2 % of post-transplant cases develops clinically relevant stones as compared to general population [6]. As the kidney is denervated patient will not suffer typical renal colic. b) Imaging appearance: Calculus appears as strongly reactive focus of variable size producing acoustic shadowing on USG and twinkling artifact on colour Doppler (Figure 5). Other rare urologic complications are ureteric necrosis and vesico-ureteric reflux.

Figure 5: Grey scale USG image of transplanted kidney show echogenic focus with acoustic shadowing (A) in lower calyceal system, (B) in upper calyceal system, (D) in mid part of transplanted ureter and (C) with twinkling artifact on colour Doppler favoring calculus.

Peritransplant Fluid Collections

Fluid collection in peritransplant region has been reported in up to 50 % of renal transplantation. They are urinomas, hematomas, lymphocele and abscess, the clinical relevance of these collection is largely determined by their size, location and possible growth. In immediate postoperative period, small hematomas or seroma are almost expected. Their size should be documented at baseline examination. Rarely do they lead to graft dysfunction or obstruction of collecting system. Urinomas and hematomas are most likely to develop immediately after transplantation, whereas lymphoceles generally develop after 4 to 8 weeks. The ultrasonography characteristics of peritransplant fluid collections, however, are entirely nonspecific, correlation with clinical findings helps to restrict differential diagnosis. Ultimately, diagnosis may be made only with percutaneous aspiration and then biochemical analysis. Differentiation between Peritransplant and subcapsular collection is important. A subcapsular collection likely to cause mass effect on parenchyma, usually cresenteric and show extension along the contour of kidney deep to the renal capsule

Hematoma

a. Incidence: Varies from 4 to 8 % [7] b. Imaging appearance: Hematomas have a complex appearance. Hematomas appears echogenic in acute case and progressively become less echogenic with time (Figure 6). Chronic hematomas even appear anechoic, more closely resembling fluid and septation may develop later on.

Figure 6: Grey scale USG image shows echogenic collection in (A) at subcapsular region, (B) in peritransplant region favoring hematoma.

Lymphocele

a. Incidence: Affecting up to 20% of the patients [8] It occurs after surgery owing to the surgical disruption of the normal lymphatic channels along the iliac vessels or around the hilum of the graft. b. Imaging appearance: on Ultrasound it appears as anechoic bur may contain septation. They may become infected and gave more complex appearance (Figure 7).

Peritransplant abscesses

a) Imaging appearance: USG cannot always differentiate an abscess from other collection. Collection may show low level echoes and thick irregular wall. If gas is seen, an abscess is probable. In any pyrexia patient, any perinephric collection should be considered infected until proven otherwise through the appropriate imaging and guided diagnostic aspiration.

Figure 7: Grey scale USG image showing septated collection (A) near lower pole of transplanted kidney, (B) causing compression over renal pelvis and resulting in obstructive changes in transplanted kidney favoring lymphocele.

Parenchymal Complication / Graft Dysfunction

Diseases of the renal parenchyma are usually diffuse and often leads graft dysfunction. Differential diagnosis is difficult by imaging alone. USG is not sensitive or specific for evaluation; differential will be relying on biopsy. USG still has a central role in qualitative assessment of graft perfusion and to guide the biopsy.

Acute tubular necrosis (ATN)

Acute tubular necrosis is due to reversible ischemic damage to the renal tubular cells prior to engrafting and reperfusion injury. i. Incidence: affects 20–60 % of cadaveric renal grafts. ii. Time of onset: in the first 48 hours after transplantation. iii. Imaging appearance: No specific imaging pattern for the diagnosis of ATN. The kidney may appear normal, in severe cases it looks enlarged, edematous and echo poor with loss of corticomedullary differentiation (Figure 8) and shows elevated RI (above 0.8).

Figure 8: Grey scale USG image showing edema to us transplanted kidney with prominent pyramids and decreased cortical echogenicity may favors changes of Acute tubular Necrosis (ATN) or Acute Rejection (AR).

Rejection

Rejection can be classified according to the period of appearance as hyper acute (occurring within minutes), acute (occurring within days to weeks), late acute (occurring after 3 months), or chronic (occurring months to years after transplantation). Classification of renal allograft rejection by Banff classification of allograft pathology is routinely followed nowadays. It is based on a combination of histopathologic features coupled with molecular, serologic, and clinical parameters.

Acute Rejection (AR)

i. Incidence: up to 40% of patients in the early transplant period [9].

Figure 9: (A) Grey scale USG image shows enlargement of transplanted kidney, swelling of the medullary pyramids and echogenic sinus fat, (B) Spectral Doppler analysis shows elevated RI may favors changes of Acute Rejection (AR) or Acute Tubular Necrosis (ATN).

ii. Imaging appearance: Graft enlargement due to edema, Decreased cortical echogenicity, swelling of the medullary pyramids, echogenic sinus fat, edematous wall of pelvic calyceal system, focal hypoechoic areas in parenchyma which may favors infarct and collection in perigraft region due to necrosis or hemorrhage. PI and RI elevated in both ATN as well as in AR, but AR has high values of it. In severe cases, Power Doppler shows reduced, absent or reversed diastolic flow with elevation of the RI (Figure 9).

Chronic Rejection

Chronic rejection occurs in case of insufficient immunosuppression given to recipient to control the residual antigraft lymphocytes and antibodies. i. Imaging appearance: US appearance is not typical, ranging from normal to hyper echogenic, along with cortical thinning, reduced number of intrarenal vessels, and mild hydronephrosis (Figure 10). RI measurements are not reliable for this diagnosis. The diagnosis is made histologically.

Figure 10: (A) Grey scale USG image shows echogenic transplanted kidney with cortical thinning and minimal hydronephrosis, (B) Spectral Doppler image shows reduced diastolic flow and elevated RI may favors Chronic Rejection.

Drug Nephrotoxicity

Calcineurin inhibitors are key immunosuppression agents administered to avoid acute rejection, but they are nephrotoxic. A. Imaging appearance: USG may show completely normal results or nonspecific findings such as graft swelling, increased or decreased renal echogenicity and loss of cortico-medullary differentiation. Doppler study may show a RI increase of 0.80. Findings of USG and Doppler study should be correlated with the serum drug levels. USG and Doppler findings of ATN and AR is almost similar, but both can be differentiated by time course of the findings. Clinical & biochemical correlation and serial measurements of RI and Pulsatile index (PI) would be further helpful to monitor the patient.

Infections and abscesses

Incidence and time of onset: More than 80% of renal transplant recipients have at least 1 episode of infection during the first year of post transplantation.

Figure 11: Grey scale USG image shows ill-defined hypoechoic lesion (A) in mid pole, (B) in upper pole of transplanted kidney posteriorly Suggestive of Abscess formation. First one is proved case of fugal etiology and second one is pyogenic abscess.

I. Imaging appearance: USG appearance is quite variable. Focal pyelonephritis appear as a focal hyperechoic or hypoechoic area, but this finding is nonspecific because it can represent infarction or rejection also (Figure 11). Abscess has varied appearance on USG like- heterogeneous, hypoechoic or cystic. Urothelial thickening may be seen. In febrile post renal transplant patient low level echoes in dilated collecting system may favors pyonephrosis. Fungus ball appears as focal rounded, weakly shadowing or echogenic structure in dilated pelvic calyceal system. In emphysematous pyelonephritis, gas in the parenchyma of the renal graft produces an echogenic line with distal reverberation artifacts. Papillary necrosis has no typical sonographic findings, and it subsequently leads to ureteric obstruction.

End stage disease

Nonfunctional renal grafts are left in place in abdominal cavity. Gradually graft becomes small and can have fatty replacement, hydronephrosis, infarcts, hemorrhage or calcification.

Vascular Complications

Vascular complications in post renal transplantation have significant negative influence of graft survival. They are infrequent, occur in approximately 1%–2%; [10] but can cause sudden loss of renal allograft. Selective catheter angiography is the gold standard for diagnosis; however, it is invasive and may cause various complications. Hence it is not used as a screening tool but reserved for patients with inconclusive results on the noninvasive screening tests. Noninvasive imaging like ultrasound, Doppler, scintigraphy, CT and MR angiography plays major role to evaluate them.

Renal artery thrombosis (RAT)

Incidence: Ranges from 0.5% to 3.5 % [11] Imaging appearance: No evidence of any arterial or venous flow noted on color, spectral and power Doppler study (Figure 12). Doppler sonography had 100% sensitivity and specificity for diagnosis and hardly any other imaging study is required for diagnosis [12].

Figure 12: (A) Grey scale USG image, (B) Power Doppler image of transplanted kidney show enlargement and absent colour flow Suggest Vascular Thrombosis.

Focal Renal Infarction

Imaging appearance: A segmental infarct appears as a poorly marginated wedge shaped hypoechoic mass or a hypoechoic mass with a well-defined echogenic wall without colour flow (Figure 13). If the infarction is global, the kidney will appear hypoechoic and be diffusely enlarged.

Figure 13: Colour Doppler image of transplanted kidney shows absent colour flow (A) in upper and mid pole, (B) in upper pole favoring Segmental infarct.

Renal Artery Stenosis (RAS)

Incidence: It has wide range varying from 1% to 23 % depending on the definition and diagnostic techniques used.

Site: usually at anastomotic site

Imaging appearance: On gray scale USG, there is lack of normal post-transplant hypertrophy. On color Doppler study appearance of focal color aliasing noted at stenotic segments. On spectral Doppler study, peak systolic velocity in main renal artery >300 cm/sec and Ratio of PSV in transplanted main renal artery and external iliac artery greater than or equal to 1.8 are highly suggestive of significant stenosis. Indirect criteria are low resistive index <0.56, Acceleration time >0.07 sec, Acceleration index <3 meter/ sec and Intrarenal tardus–parvus waveform (Figure 14).

Figure 14: Spectral Doppler image shows (A) elevated peak systolic velocity in main renal artery at anastomosis, (B) delayed systolic upstroke and rounding of systolic peak consistent with tardus parvus spectral waveform in case of transplanted renal artery stenosis.

Limitation: Results are strongly depends on the operator’s individual experience and skill. Rate of restenosis is less than 10 %. Doppler ultrasonography is the procedure of choice to evaluate graft perfusion before and after revascularization The term pseudo transplant renal artery stenosis (TRAS) refers to thrombosis or stenosis of iliac artery or aorta proximal to transplant renal artery.

Renal vein thrombosis: (RVT)

Figure 15: (A) Grey scale USG image shows swollen and hypo echoic transplanted kidney, (B) Colour Doppler image shows absent venous flow and spectral Doppler image shows absent and reversal of diastolic flow in renal artery favoring Renal vein thrombosis.

Incidence: Ranges from 0.9% to 4.5 % [13]

Imaging Findings: Graft appears swollen and hypoechoic.

Doppler shows absent venous flow. Renal arterial Doppler spectrum shows absent or reversal of diastolic flow due to increased resistance (Figure 15). Reversal flow in renal artery is nonspecific as it also seen in severe rejection and in acute tubular necrosis, its combination with absent venous flow is the diagnosis of renal vein thrombosis. Partial thrombosis also can occur near anastomosis or within the transplanted kidney (Figure 16).

Figure 16: Spectral Doppler image shows (A) partial thrombosis in renal vein near anastomosis (white straight arrow), (B) partial thrombosis in main renal vein (white straight arrow) and adjacent renal pelvis showing DJ Stent (curved whited arrow) in two different cases. Intra renal venous flow is very well demonstrated and appears normal Suggest Partial renal vein thrombosis.

Extra parenchymal pseudo aneurysm

Incidence: Anastomotic pseudoaneurysm is a rare complication of renal transplantation occurring in 0.3%. [14]

Imaging findings : On gray scale ultrasound it appears as cystic lesion which shows color flow and to and fro spectral pattern on doppler study(Figure 17). Endovascular treatment with covered stent placement to exclude pseudoaneurysm can also be evaluated with USG and colour doppler (Figure 18).

Figure 17: (A)Grey scale USG image of transplanted kidney shows cystic lesion near anastomosis which shows color filling in Colour Doppler image(white arrow), (B) Colour Doppler image shows colour filled out pouching near anastomosis(white arrow) confirmed non thrombosed extra parenchymal pseudo aneurysm in two different cases.

Figure 18: (A) Two echogenic line structure(Stent) in main anastomotic renal artery in gray scale USG image of transplanted kidney, (B) Colour doppler image shows partially colour filled pseudoaneurysm at anastomosis with stent suggest Imaging findings of endovascular treatment with covered stent placement.

Intra-parenchymal arteriovenous fistula and pseudoaneurysm

AVF occurs when both artery and vein are simultaneously lacerated, while pseudoaneurysm results when only artery is lacerated. Incidence: 1-18% of the biopsies [15] Time of onset: occur at time of biopsy. They depend on many factors – ultrasound guidance, needle caliber and imaging follow up. Imaging appearance: colour Doppler study shows AVF as focal areas of disorganized flow adjoining the normal vasculature. Spectral waveforms show increased arterial and venous flow with high velocity and low resistance (Figure 19). Pseudoaneurysm appears as simple or complex cyst on B mode ultrasound and intracystic flow on colour Doppler mode (Figure 20).

Figure 19: (A) focal colour aliasing at lower pole of transplanted kidney in colour doppler image, (B) Spectral Doppler evaluation demonstrates high velocity, low impedance waveform with increased diastolic flow Suggest arteriovenous fistula (AVF) in doppler evaluation after biopsy.

Figure 20: (A) Grey scale USG image shows cystic lesion in lower pole of transplanted kidney in grey scale USG image, (B) colour Doppler image shows intra cystic flow Suggest intra parenchymal pseudo aneurysm.

Neoplasms after renal transplantation

Post renal transplantation patients are at higher risk of development of neoplasms. Urologic tumour are 4 to 5 times more common in post renal transplantation recipients than normal population with significant exposure to cyclophosphamide immunosuppressant agent.

Renal cell carcinoma

Etiology: by means of transplanted organ or de novo development by immunocompromised status, patients on hemodialysis in case of chronic renal failure develop acquire renal cystic disease Prevalence: 90 % occurring in native kidney and 10 % in transplanted kidney [16] Imaging appearance: lesion appear heterogeneous with vascularity, similar picture as seen in native kidney [17] (Figure 21).

Figure 21: Gray scale ultrasound image of transplanted kidney shows (A) heterogeneous mass lesion at the upper pole (white arrow) with internal hypoechoic region (asterisk) suggesting necrosis, (B) the mass lesion showed internal as well as peripheral vascularity on color Doppler study. Suggest renal cell carcinoma in transplanted kidney.

Lymphomas

Incidence: 1 % of renal allograft recipients [18] Time of onset: Post transplantation lymphoproliferative disorder is diagnosed at a median of 80 months after transplantation. Imaging appearance: Lymphadenopathy at various sites but can also affect any solid organ or hollow viscera or transplant graft parenchyma itself. It appears as low or mixed reactive masses and tends to have a predilection for the renal hilum.

Recurrent Native disease

It depends on the primary disease before transplantation. Imaging appearance: Imaging has no specific pattern in these situations apart from excluding the treatable cause of reduced renal function.

Abdominopelvic Complications

Renal graft is placed in extraperitoneal space via a peritoneal window in laparoscopic and robot assisted surgical techniques. So these cases are prone to same complications experienced by other surgical cases in whom peritoneum is exposed.

Renal Allograft Compartment Syndrome (RACS)

It is a rare syndrome, and it is under recognized cause of early transplant dysfunction or even loss. It may occur as a result of intracompartment hypertension and ensuring ischemia of renal graft [19]. Imaging appearance: absent or diffuse diminished cortical flow in transplant kidney at colour Doppler.

Fascial dehiscence and bowel or allograft evisceration

They tend to occur in perioperative period. Herniation of bowel through a transplant peritoneal defect may lead to compromise of intestine or transplant itself.

Limitations

The USG examination is examiner dependent and limited accessibility in obese patents impairs the evaluation and often leads misinterpretation. The RI index is also unspecific and influenced by many factors like site at which the RI is measures, increased intraabdominal pressure during forced inspiration and the pulse rate.

Summary

Kidney transplant is the treatment of choice for patients with end-stage renal disease. Improvements in surgical techniques and advanced immunosuppressive drugs have resulted in remarkable survival of patients and renal grafts. Still complications occur in both the early postoperative period and later. Kidney transplants follow up is common in radiology and sonography practice. Ultrasonography and Doppler examination can accurately depict and characterize many of the potential complications of renal transplantation. It facilitates prompt and accurate diagnosis and thus guiding treatment.

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[helthcareheven]

Discovering Healing Havens: A Guide to Medical Tourism

Reasons for Seeking Medical Care Abroad

One of the primary factors driving the growth of surgical tourism is the high cost of healthcare in developed countries. For many elective and non-emergency procedures, the costs in the United States, Canada, United Kingdom and other Western nations have become prohibitively expensive for average citizens and even those with health insurance. Medical tourists are able to travel abroad and receive treatments at a fraction of the price they would pay at home. In many destination countries, the overall package of medical care, travel, lodging and other ancillary costs is 30-90% cheaper than equivalent treatment in a developed country.

Another motivation is shorter wait times. In countries with universal healthcare systems, there can be lengthy waits for non-emergency surgeries and procedures. The average wait time for a hip replacement in Canada is over 6 months, while knee replacements in the UK have 18-month waits. By traveling abroad, medical tourists are able to get treated more quickly without delay. India, Thailand and other popular destinations generally have minimal to no wait times.

Medical Specialties and Treatments Sought

While originally centered around dental care and cosmetic surgeries, medical tourism has expanded to cover a wide range of specialties and treatments. Some of the most common include:

- Cardiology - Angioplasty, angiography, bypass surgery and stent placement are popular cardiological procedures sought by medical tourists.

- Orthopedics - Knee replacement, hip replacement, spinal surgery and arthroscopic procedures feature prominently. The use of robotics and computer navigation systems allows for less invasive techniques.

- Dentistry - Dental crowns, veneers, dental implants and oral surgery make up a major portion of surgical tourism, especially to Thailand, Hungary and Mexico.

- Fertility Treatment - In vitro fertilization (IVF) costs a fraction abroad versus in the Western world. Countries like India, Thailand and Cyprus attract fertility tourists.

- Cosmetic Surgery - Tummy tucks, breast augmentations, face lifts and other aesthetic procedures drive traffic to countries such as Thailand, South Korea and Costa Rica.

- Ophthalmology - Cataract removal and lens replacement surgeries are commonly sought abroad alongside refractive procedures like LASIK eye surgery.

Popular Medical Tourist Destinations

Certain countries have built strong reputations as top destinations in medical tourism. Some of the leaders are:

India - Advanced facilities, JCI-accredited hospitals, large pool of English-speaking doctors and very low costs have made India the world's fastest growing market. The Indian healthcare sector earns over $3 billion yearly from medical tourists.

Thailand - Known especially for quality dental and cosmetic work at bargain prices. Thais are perceived as being quite skillful with bedside manner. Hospitals meet international standards.

Singapore - Highly developed medical infrastructure, including the promotion of integrated surgical tourism clusters with hotels. Singapore attracts Asian patients as well as those from the West.

Malaysia - Healthcare quality equals that of Western countries at half the cost or less. Malaysia Medical Council regulates facilities, and English is widely spoken in the healthcare industry.

Mexico - Popular for procedures like dental work, bariatric surgery, and eye/laser corrective surgeries due to competitive pricing. Many accredited JCI hospitals near the US border.

Challenges and Risks of Medical Tourism

While surgical tourism provides considerable benefits, certain risks and challenges exist that need to be considered. Post-surgical complications may arise, and standards of aftercare can vary in different countries. The legal recourse and patient rights available may not equal what patients expect at home. Medical records and follow-ups may be difficult between multiple healthcare systems. Travel itself poses some health threats like the transmission of new infections or bacterial strains. Cultural differences, language barriers or unfamiliar practices can affect the levels of comfort experienced abroad. Medical tourists need to carefully vet facilities and providers through organizations that accredit and certify hospitals overseas. With prudence, most risks can be minimized to allow patients to reap the rewards of affordable, timely medical care in internationally accredited centers worldwide.

Growth Outlook

The global medical tourism industry was estimated to be worth around $10-40 billion worldwide as per different surveys. Advanced Asia-Pacific destinations capture approximately 45-65% market share of the entire pie while the remainder is split between Latin America, Eastern Europe, Middle East, Africa and other regions. India alone serves an estimated 150,000-200,000 medical tourists every year currently. Going forward, the worldwide numbers are forecasted to grow substantially in the coming years. Driven by factors like the shrinking value of most foreign currencies against the USD, an expanding medical infrastructure abroad, more trade agreements lowering travel barriers, and persistent high healthcare costs domestically – surgical tourism is emerging as a multi-billion dollar industry worldwide with potential for further significant increase in the future if present trends continue.

#HealingDestinations #WellnessAbroad #HealthcareGetaways

[drchandrakant01]

Exploring the Advancements in Neuro-Interventional Radiology: Revolutionizing Neurological Care

In the dynamic landscape of modern medicine, the field of neuro-interventional radiology stands as a beacon of innovation, reshaping the way we approach and treat neurological conditions. With its amalgamation of radiology, neurology, and interventional techniques, neuro-interventional radiology (NIR) offers a spectrum of minimally invasive procedures that are proving to be game-changers in the realm of neurological care.

NIR encompasses a diverse array of procedures aimed at diagnosing and treating conditions affecting the brain, spinal cord, head, neck, and associated blood vessels. These procedures are conducted under image guidance, typically using fluoroscopy and angiography, enabling precise navigation through intricate neural pathways with minimal disruption to surrounding tissues.

One of the most ground-breaking applications of NIR lies in the treatment of ischemic stroke, a leading cause of disability and mortality worldwide. Through techniques such as mechanical thrombectomy, neuro-interventional radiologists can swiftly remove blood clots obstructing major cerebral arteries, restoring blood flow to the affected area and salvaging precious brain tissue. This timely intervention has significantly improved outcomes for stroke patients, reducing long-term disability and enhancing quality of life.

Beyond stroke management, NIR plays a pivotal role in the treatment of cerebral aneurysms, arteriovenous malformations (AVMs), and other vascular abnormalities of the brain. By deploying endovascular coils, stents, and embolic agents, neuro-interventionalists can effectively occlude abnormal blood vessels or reinforce weakened arterial walls, mitigating the risk of rupture and hemorrhage.

Furthermore, NIR offers innovative solutions for the management of brain tumors and intracranial hemorrhages. Through techniques like intra-arterial chemotherapy and embolization, clinicians can deliver therapeutic agents directly to tumor sites or staunch bleeding vessels, circumventing the need for open surgery and reducing associated risks and recovery times.

The evolution of imaging technologies has been instrumental in advancing the frontiers of NIR. High-resolution imaging modalities such as digital subtraction angiography (DSA), magnetic resonance angiography (MRA), and computed tomography angiography (CTA) provide neuro-interventionalists with unparalleled insights into the intricate anatomy and pathology of the central nervous system, enabling precise procedural planning and execution.

Moreover, the integration of robotics and artificial intelligence (AI) into NIR workflows holds tremendous promise for enhancing procedural accuracy and efficiency. Robotic-assisted systems offer unparalleled precision in catheter navigation, while AI algorithms aid in image interpretation, lesion detection, and treatment planning, augmenting the capabilities of clinicians and improving patient outcomes.

Despite its transformative potential, neuro-interventional radiology is not without challenges. Access to specialized training and resources, as well as the high cost of equipment and procedures, remain barriers to widespread adoption. Additionally, concerns regarding radiation exposure and procedural complications underscore the importance of rigorous training, adherence to safety protocols, and ongoing research to refine techniques and mitigate risks.

In conclusion, neuro-interventional radiology stands at the forefront of modern medicine, offering a paradigm shift in the management of neurological disorders. With its emphasis on minimally invasive techniques, precise imaging guidance, and multidisciplinary collaboration, NIR holds the promise of revolutionizing the landscape of neurological care, ushering in a new era of hope and healing for patients worldwide. As technology continues to evolve and expertise expands, the potential of NIR to transform lives and redefine the boundaries of possibility in neurology remains boundless.

#neuro interventional radiology

[drrajivagarwal2]

Coronary Angiography Treatment in Delhi

If you're in Delhi NCR and in need of Coronary Angiography Treatment in Delhi, don't hesitate to schedule an appointment with Dr. Rajiv Agarwal. As the best coronary angiography doctor in Delhi, he will provide you the best Coronary Angiography Treatment in Delhi.  He has more than 30 years of experience in diagnosing and treating heart conditions. With his compassionate approach and personalized treatment plans, you can trust that you're in good hands. Contact him today to take the first step towards better heart health. He uses the latest techniques and technology to ensure accurate diagnoses and effective treatment plans. Currently he practices at Max Smart Super Speciality Hospital, Saket, New Delhi.

#Best Coronary Angiography Doctor in Delhi #Coronary Angiography cost in Delhi NCR #Coronary Angiography Doctors in Delhi NCR

[imdockunal]

Dr. Kunal Arora: Revolutionary Interventional Radiologist in Borivali, Mumbai

Are you seeking the Best interventional radiologist in Borivali, Mumbai? Meet Dr. Kunal Arora, a trailblazer in Vascular and Interventional Radiology, patient care with his expertise and dedication.

Understanding Interventional Radiology

Definition: Interventional radiology (IR) is a medical specialty that utilizes minimally-invasive procedures guided by medical imaging techniques like x-ray fluoroscopy, CT, MRI, or ultrasound.

Purpose: IR serves both diagnostic and therapeutic purposes, allowing for precise treatments through small incisions or body orifices.

Benefits: The key advantages of IR include reduced risks, pain, and recovery time compared to traditional open procedures, along with real-time visualization for accurate diagnosis and treatment.

Common Elements: IR procedures typically involve tools like puncture needles, guidewires, sheaths, and catheters, along with medical imaging machines for guidance.

Diagnostic IR: Includes procedures like angiography, which aids in diagnosing and treating conditions such as aneurysms and arterial obstructions.

Therapeutic IR: Involves treatments like embolization for conditions like gastrointestinal hemorrhage and transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension.

Procedural Room Setup: Proper organization of the IR suite, procedural table, and equipment is crucial for efficiency, safety, and optimal image quality during procedures.

Advancements: Continuous technological advancements in IR expand the scope of treatable conditions, offering patients minimally invasive alternatives to traditional surgeries.

The advantages of interventional radiology over other medical treatments

The advantages of interventional radiology over other medical treatments include:

Minimally Invasive: IR procedures are minimally invasive, requiring only small incisions and often performed on an outpatient basis, leading to reduced risks, less pain, and faster recovery times compared to traditional open surgeries.

Precise and Targeted Treatment: Interventional radiologists use medical imaging technology to guide procedures, ensuring high accuracy in diagnosis and treatment, which enhances patient outcomes.

Reduced Risks: IR procedures mitigate risks such as major blood loss, infections, and damage to surrounding tissues, making them safer alternatives to traditional surgeries.

Suitable for More Patients: IR is suitable for patients who may not be eligible for general anesthesia or traditional surgeries due to underlying health conditions like diabetes, obesity, or high blood pressure.

Quick Recovery: Patients undergoing IR procedures experience quicker recovery times, allowing them to return to their daily lives sooner than with traditional surgeries.

No Hospital Stay: Most IR procedures are done on an outpatient basis, eliminating the need for hospitalization and enabling patients to go home the same day of treatment.

Cost-Effective: IR treatments are often less costly than inpatient hospital stays, and some facilities offer minimal out-of-pocket expenses, making them a cost-effective option for patients.

Versatility: IR procedures can address a wide range of health conditions, from uterine fibroids and varicose veins to cancer treatments and pain management, showcasing the versatility of this medical specialty.

Better Results: IR procedures can yield results that are as good as or even better than traditional treatments, making them a compelling choice for patients seeking effective and efficient medical interventions.

Academic and Professional Background of Dr. Kunal Arora, Best Interventional Radiologist in Mumbai:

Graduated from Grant Medical College, Mumbai

Completed MD in Radio-diagnosis from Dr. DY Patil Medical College, Navi Mumbai

Extensive experience at prestigious institutions in the USA

Senior Resident at Dr. DY Patil Medical College, honing skills in Interventional Radiology

Specialization and Expertise:

Fellowship at Government Medical College, Nagpur, focusing on complex cases

Specializes in minimally invasive treatments for varicose veins, DVT, embolization, and more

Known for hepatobiliary interventions and dialysis AV fistula salvage

Clinical Affiliations:

Affiliated with Wockhardt Hospitals, Mira Road, and other prestigious hospitals in Mumbai

Known for providing high-quality care and innovative treatments

Dr. Kunal Arora shines as the Best Interventional Radiologist in Borivali, Mumbai, with a stellar academic background, extensive expertise, and a passion for research. Trust Dr. Arora for cutting-edge, minimally invasive solutions tailored to your healthcare needs. Experience top-notch care and innovation with the leading expert in Vascular and Interventional Radiology.

For those seeking more information, the Endovascular Care Centre is conveniently located at Dattapada Road, Off Western Express Highway. To schedule an appointment, you can reach out to Dr. Kunal Arora via email at [email protected] or Contact Us [phone] or 98922 88400.

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[hridayicaclinic12]

Coronary Angiography Treatment in Delhi

Coronary angiography is a medical procedure that allows doctors to examine the inside of the blood vessels in the heart. It's an essential tool for diagnosing and treating a wide range of heart conditions, including heart attacks, angina, and coronary artery disease. During the procedure, a small catheter is inserted into the blood vessels, usually in the arm or groin, and advanced into the heart. A contrast dye is then injected into the catheter, which makes the blood vessels visible on X-rays. This allows doctors to identify blockages, narrowings, or other abnormalities in the blood vessels that supply the heart. If you're looking for the best coronary angiography treatment in Delhi, you need look no further than Dr. Vivek Kumar. Dr. Kumar is one of the top coronary angiography doctors in Delhi NCR, with years of experience and a proven track record of success. He practices at the Indraprastha Apollo Hospitals in Sarita Vihar, New Delhi, which is one of the top hospitals in the city. This is the top Hopital of Delhi and here Coronary Angiography cost in Delhi NCR is affodable as compared to other Super Speciality Hospitals. Another benefit of choosing Dr. Kumar for your coronary angiography treatment is that he works closely with his patients to ensure that they feel comfortable and well-informed every step of the way. He takes the time to explain the procedure, answer questions, and address any concerns that patients may have. His compassionate and personalized approach to patient care has earned him a reputation as one of the most trusted and respected doctors in the region. If you need coronary angiography treatment in Delhi, Dr. Vivek Kumar is the best choice. With his years of experience, personalized approach to patient care, and commitment to affordable and transparent pricing, you can trust him to provide you with the best possible care. Contact him today to schedule a consultation and take the first step towards a healthier heart.

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[indianhealthguru]

Saving Hearts, Saving Wallets: Affordable Cardiac Surgery Choices in Delhi

Overview:

Cardiac surgery refers to surgical procedures performed on the heart and its blood vessels. The most prevalent heart surgery is coronary artery bypass grafting. In addition to this, heart surgery is utilized to repair or replace heart valves, implant devices to support blood flow and improve heart function. Cardiac surgery can also involve heart transplants using a donor heart. Typically, the journey towards a heart disease diagnosis begins with your primary care physician, who may then refer you to a cardiologist. Coronary artery disease is one of the most frequently treated conditions by cardiothoracic surgeons.

Types of coronary heart surgeries in India

Here is a list of some of the most renowned cardiac surgeries in India that medical travelers prefer:

Open Heart Surgery

Coronary Angiography

Coronary Artery Bypass Grafting

Aneurysm Repair

Tran myocardial Laser Revascularization

Valve Replacement/Repair

Arrhythmia Treatment

Heart Transplant

Affordable cost of cardiac surgery in Delhi is proven to be an excellent option

Affordable cost of cardiac surgery in Delhi is approximately one-tenth of the cost in the United States. The overall affordable cost of cardiac surgery in Delhi varies based on factors such as the type of procedure, the patient's medical condition, the medical practitioner involved, the infrastructure, and the chosen treatment center. Affordable cost of cardiac surgery in Delhi typically starts from USD 6000-7000 and can vary depending on the aforementioned components. The significant advantage of opting for affordable cost of cardiac surgery in Delhi is the potential to save thousands of dollars. Highly advanced robotic heart surgery in India is available at an exceptionally affordable cost compared to the global average.

The affordable cost of cardiac surgery in Delhi attracts numerous Ethiopia patients each year, particularly for various types of cardiac surgeries. India's top-rated medical facilities guarantee that patients receive outstanding medical treatment at a fraction of the cost compared to Western countries. The affordable cost of cardiac surgery in Delhi ensures that Ethiopia people from all walks of life can access top-notch medical services.

Top heart hospitals in Delhi is considered the most appropriate for cardiac procedure

The top heart hospitals in Delhi have earned their reputation as premier destinations for several compelling reasons. These hospitals excel in high-end robotic surgeries, boasting advanced systems and state-of-the-art facilities staffed by highly skilled and experienced healthcare professionals. What sets these top heart hospitals in Delhi apart is their ability to offer healthcare services at remarkably affordable rates without compromising on quality, making them a preferred choice for Ethiopia patients worldwide.

The top heart hospitals in Delhi maintain exceptional quality standards and have a skilled team of surgeons proficient in the use of robotic surgery in India. The combination of experienced surgeons and low-cost robotic surgery in India enables patients to find effective solutions for their medical conditions. Importantly, all of the top heart hospitals in Delhi hold JCI/NABH accreditation, further underscoring their commitment to delivering top-notch healthcare. These top heart hospitals in Delhi have made significant contributions to the field of cardiology, consistently providing Ethiopia patients with the highest level of satisfaction.

Start your journey to good health with Indian health guru consultant

Indian health guru consultant is a medical facilitator that enables patients to access high-quality, cost-effective treatment in the global healthcare market. Our extensive healthcare network includes top hospitals and highly reputed medical professionals known for their excellence, ensuring that international patients receive the best possible care. Our team of experts coordinates the patient's entire medical journey, which also encompasses pre-departure consultation and on-site services. We are among the leading medical providers in India, offering tailored and affordable cost of cardiac surgery in Delhi to cover your medical treatment and travel needs.

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[atulayahealthcare]

PET CT Scan at Atulaya Healthcare: Shaping a Healthier Tomorrow  

Atulaya Healthcare stands as a beacon of hope and progress in the realm of medical care, actively contributing to the building of a better future. With comprehensive services ranging from complete full-body checkups to cutting-edge PET CT scans and top-tier pathology labs, Atulaya Healthcare ensures holistic wellness and early detection of ailments. Moreover, it offers cost-effective solutions like angiography, making advanced medical diagnostics accessible to all. 

In today's fast-paced world, preventive healthcare has become paramount. Atulaya Healthcare recognizes this and goes beyond mere treatment by emphasizing proactive measures through routine checkups. Their complete full-body checkup packages are tailored to suit individual needs, empowering patients with valuable insights into their health status and enabling them to make informed decisions for a healthier lifestyle. 

In the fight against complex diseases like cancer, early detection is key. Atulaya Healthcare's state-of-the-art PET CT scan facilities are at the forefront of this battle, providing accurate and timely diagnosis to facilitate prompt intervention. This not only improves patient outcomes but also alleviates the burden on healthcare resources by minimizing the need for prolonged treatments. 

Furthermore, Atulaya Healthcare boasts the best pathology lab services, equipped with advanced technology and staffed by experienced professionals. From routine blood tests to specialized investigations, patients can trust in the accuracy and efficiency of their results, paving the way for precise diagnosis and tailored treatment plans. 

Affordability is often a barrier to accessing essential medical services. Recognizing this, Atulaya Healthcare endeavours to make critical procedures like angiography more accessible to the masses. By offering competitive pricing without compromising on quality, they ensure that financial constraints do not hinder individuals from seeking necessary medical care. 

In essence, Atulaya Healthcare's commitment to excellence, innovation, and inclusivity is not just about addressing current healthcare needs but also about laying the foundation for a healthier and more prosperous future. By prioritizing preventive care, leveraging advanced technology, and promoting affordability, Atulaya Healthcare is truly shaping a better tomorrow for all. 

#diagnostic #healthcare #ct scan