Palliative Gastrointestinal Interventions

Introduction Interventional radiology offers several palliative procedures resulting in improvement of quality of life for terminally ill patients, which are often overlooked and are unknown to non-radiology physicians.

Content Outline In this educational exhibit, we will discuss and provide a pictorial review of the various palliative procedures performed by interventional radiology at our multi-center academic healthcare system for gastrointestinal-related malignancies. The clinical indications, patient selection criteria, contraindications, technique, complications, and results of the procedures will be examined. The cases include portal vein recanalization, biliary drain placement, and stenting in the setting of obstructive malignancy as well as celiac plexus cryoablation/block for chronic pain relief (i.e., pancreatic cancer). Also, percutaneous decompression gastrostomy tube (PDGT) placement for patients with malignant bowel obstruction and pleural/abdominal drainage catheters for malignant effusions will be discussed. Furthermore, we will explore ablations, chemo- and radio-embolization, and bland embolization of hepatic tumors in the setting of palliative care. Procedures, such as kyphoplasty, vertebroplasty, and ablation of osseous metastasis for pain relief will also be discussed in detail. Lastly, we will review cases demonstrating palliative treatment of venous and arterial thromboses related to malignancy.

Learning Points Interventional radiology plays an important role in the multidisciplinary field of palliative care by offering a wide range of minimally invasive procedures to increase the quality of a patient's life and to achieve goals of care.