Interventional radiology procedures in critically ill cancer patients

Interventional radiology provides a wide scope of procedures to address the palliative needs of the critically ill cancer patient. The specialty spawned decades ago to apply image guidance to relieve and treat pathology in a minimally invasive manner. All procedures are performed through the advancement of low-profile needles and small-caliber drains under direct observation with ultrasound, fluoroscopy, computed tomography, or magnetic resonance imaging. Interventions to prevent or treat acute disease in the critically ill cancer can be grouped into the broad categories of central venous access, enteric access, drainage of obstructed or infected fluid, correction of vascular obstruction, occlusion of active bleeding, and pulmonary embolus prevention and treatment. This chapter provides a concise review of the interventional radiology procedures within each category. General indications and pragmatic considerations are discussed to illustrate the procedural applications as they pertain to the critically ill cancer patient.