Beyond the Bile Duct: Advanced IR Endoscopic Interventions Involving the Gastrointestinal, Genitourinary, and Musculoskeletal Systems

Abstract

Endoscopy is a technique used by interventional radiology (IR) in only a few centers throughout the United States. When used by IR, endoscopy is most well-known for its role in the treatment of hepatobiliary disease. However, its use with relation to pathology involving the gastrointestinal (GI), genitourinary (GU) and musculoskeletal (MSK) systems is gaining momentum among IR. The purpose of this article is to demonstrate the potential benefits of IR endoscopy in non-biliary intervention. A literature review, not requiring IRB approval, was performed via PubMed and Ovid Medline databases using the search terms "interventional radiology-operated endoscopy", "interventional endoscopy", "interventional radiology", "genitourinary", and "gastrointestinal". Literature describing IR endoscopy involving the GI, GU, and MSK systems were identified and described. Nine peer-reviewed articles were identified. While few studies were identified, a general theme suggesting a synergistic relationship between IR and endoscopy was noted. More studies are needed to better understand the role of endoscopy as a technique in the IR suite.

Endoscope-Assisted Traversal of a Ureteral Stricture From Percutaneous Nephrostomy Access

“…Chick et al reported the use of a disposable ureteroscope to place a stent across the stenotic anastomosis of a pyelovesicostomy in a renal transplant patient [10]. Healey et al reported a case similar to ours, in which endoscopy was used via ileal conduit (i.e., retrograde) access to cannulate the ureters and place bilateral ureteronephric stents [4]. Nephroscopy has also been used to assist in the retrieval of migrated renal artery embolization coils [11,12].…”

“…However, the potential applications of endoscopy in interventional radiology extend beyond the biliary system. In the gastrointestinal tract, combined image-guided and endoscopic techniques have been used by interventional radiologists to (re)place percutaneous gastrojejunostomy tubes, place endoluminal stents across obstructing lesions, and retrieve foreign bodies through percutaneous access [4][5][6][7]. Interventional radiology-operated endoscopy has also been reported in musculoskeletal procedures, specifically in treating synovial chondromatosis and sequestered intervertebral disc herniation [8,9].…”