1. IMAGE GUIDED BIOPSIES/ FNAC– It is a simple painless procedures done to obtain samples for histopathological diagnosis in deep seated lesions or tumours in liver/ abdomen. Nearly all these procedures are day care procedures and performed under USGor CT imaging guidance using local anaesthesia. This allows sampling of many lesions thus avoiding open surgical sampling.

2. IMAGE GUIDED PERCUTANEOUS DRAINAGES OR DRAINAGE CATHETER– The procedures involve either aspiration or catheter drainage of pus or fluid in organs within the body mostly in peritoneal/ retroperitoneal or pleural cavity. This may belife-saving in patients where a surgery may be un-necessary especially in patients with sepsis or conditions like acute pancreatitis.

3. LIVER ABSCESS DRAINAGE/ DRAINAGE CATHETERS– It is minimally invasive procedure done under USG/CT guidance and involve either percutaneous aspiration or putting a drainage catheter in liver abscess.

4. TRANS-JUGULAR LIVER BIOPSIES AND HVPG MEASUREMENTS-Transjugular liver biopsy is an alternative route for performing biopsies in in patients with deranged blood clotting in whom a percutaneous liver biopsy cannot be performed. It involves puncturing a vein in the neck region and reaching liver by endovascular route. Hepatic vein wedge pressure can also be measured by this technique when required.

5. TIPS (TRANSJUGULAR INTRA-HEPATIC PORTO-SYSTEMIC SHUNT)-It is an artificial channel within the liver that establishes communication between the inflow portal vein and the outflow hepatic vein. It is used to treat portal hypertension (which is often due to liver cirrhosis) which frequently leads to intestinal bleeding, life-threatening esophageal bleeding (esophageal varices) and the build-up of fluid within the abdomen (refractory ascites). An interventional radiologist creates the shunt using an image-guided endovascular (via the blood vessels) approach, with the jugular vein as the usual entry site.

6. HEPATIC VEIN STENTING– They are advanced procedures involving opening of closed veins within the liver by using minimally invasive techniques.

7. BALLOON RETROGRADE TRANSVENOUS OBLITERATION OF VARICES (BRTO)– Patients with chronic liver disease often develop abnormal large gastric venous variceal dilatation which may causes significant bleeding. BRTO is a complex procedure which involves embolization of these large gastric venous dilatations via endovascular route in patients who are poorly controlled by endoscopic techniques.

8. SPLENIC ARTERY EMBOLIZATION: Splenic (artery) embolisation is an endovascular technique for treatment of splenic and splenic artery pathology as an alternative to splenic artery ligation or splenectomy. It often results in successfully treating the underlying pathology, while maintaining at least partial splenic function. It is indicated in traumatic splenic injury, particularly AAST grade III-V in haemodynamically stable patients, hypersplenism, splenic malignancy, splenic steal syndrome and splenic artery aneurysm or pseudoaneurysm

9. PTBD  and Metallic stenting– PTBD is one of the most essential procedures in cases with dilated IHBR due to failed ERCP stenting, blocked CBD stent, Distal CBD lesion with stenting not possible and in cases with non dilated system with CBD injury. If meticulously performed, this procedure is technically feasible in all cases with good success rate. It gives immediate sympomatic relief as well as brings down the levels of bilirubin down.

10. EMBOLIZATION IN EMERGENCY BLEEDING (GI BLEED)– Gastrointestinal endovascular embolization procedures can be performed for arresting bleeding from arteries within the body in the setting of trauma, inflammations, post surgery, tumoral/ aneurysmal bleeding/pancreatitis etc. These are lifesaving procedures which involve achieving access to the bleeding vessel through catheters from a small puncture in the groin or wrist artery and embolising or closing these arteries with a wide range of embolic material like coils, gelfoam or particles  to arrest the bleeding .