Vascular And Interventional Radiology

Interventional Radiology (IR) is a medical subspecialty that provides minimally invasive, image-guided treatments for a wide range of diseases throughout the body. Using advanced imaging techniques together with small catheters and needles, many procedures are performed with less pain, shorter hospital stays, faster recovery, and often without the need for general anaesthesia.

The SGH Department of Vascular and Interventional Radiology is a high-volume tertiary centre performing over 10,000 procedures annually. We work closely with multiple clinical specialties and provide IR services across Singapore General Hospital (SGH), Sengkang General Hospital (SKH), KK Women’s and Children’s Hospital (KKH) and National Cancer Centre Singapore (NCCS).

We treat conditions including vascular disease, thrombosis, cancer, bleeding, infection, musculoskeletal disorders and pain, and run outpatient clinics at SGH, SKH, KKH and NCCS, accepting both internal referrals and self-referrals.

Clinical Services

Vascular (Arterial)

• Conditions we treat:
  • Vascular malformations
  • Visceral and peripheral aneurysms; Aortic aneurysms
  • Visceral arterial disease (e.g. renal, mesenteric artery stenosis / occlusion)
  • Peripheral arterial disease
  • Dialysis fistula dysfunction
• Procedures we perform:
  • Embolisation, Sclerotherapy, Bleomycin Electrosclerotherapy (BEST)
  • Endovascular aneurysm repair (EVAR/TEVAR)
  • Angioplasty and stenting, Thrombectomy / thrombolysis
  • Percutaneous dialysis fistula creation

Vascular (Venous)

• Conditions we treat:
  • Pulmonary embolism,
  • Deep vein thrombosis, Venous compression (e.g. May-Thurner syndrome),
  • Vena cava obstruction
• Procedures we perform:
  • Pulmonary thrombectomy / catheter-directed therapy
  • Deep venous thrombectomy, Venous stenting
  • IVC filter insertion, Vena cava reconstruction

Oncology and Tumours:

• Conditions we treat:
  • Thyroid nodules and cancer (non-surgical treatment)
  • Lung tumours (primary lung cancer, lung metastases)
  • Liver tumours (hepatocellular carcinoma, cholangiocarcinoma, liver metastases)
  • Kidney tumours (renal cell carcinoma, angiomyolipoma)
  • Bone and soft tissue tumours (desmoid tumour, osteoid osteoma, metastases)
  • Interventional (non-surgical) treatment of various other tumours (e.g. head and neck, breast, soft tissue, adrenals and other viscera)
    
• Procedures we perform:
  • Image-guided tumour ablations (radiofrequency, microwave, ice / cryo)
  • Thyroid radiofrequency ablation (RFA) and Thyroid artery embolisation (TAE)
  • Histotripsy (non-invasive ablation)
  • Trans-arterial chemoembolisation (TACE)
  • Radioembolisation (Yttrium-90)
  • Long-term indwelling pleural and peritoneal catheters

Musculoskeletal and Pain

• Conditions we treat:
  • Spine: Compression fractures, Nerve root compression, Facet joint degeneration, Degenerative spine
  • Joints: Non-surgical treatment of Osteoarthritis, Haemarthrosis & Synovitis, Frozen shoulder, Elbow epicondylitis (tennis/golfer elbow), Plantar fasciitis
  • Tumours: Bone metastases, Primary bone tumours (e.g. osteoid osteoma), Soft tissue tumours (e.g. desmoid), Pathological spine and pelvic fractures
  • Others: Trigeminal neuralgia, Headache from CSF leak
• Procedures we perform:
  • Cement augmentation and osteosynthesis of spine and pelvic fractures (Vertebroplasty, Kyphoplasty, Cementoplasty)
  • Bone tumour biopsy, ablation and embolisation
  • Spinal nerve injections / neurolysis / ablation (e.g. epidural, nerve root, medial branch)
  • Epidural blood patch, Myelography (conventional and CT) for CSF leak
  • Peripheral and visceral nerve blocks / neurolysis / ablation (e.g. trigeminal nerve for neuralgia, splanchnic nerve for cancer pain, genicular nerve for knee osteoarthritis)
  • Joint aspirations / injections (e.g. PRP, corticosteroids and viscosupplementation) and radiosynovectomy
  • Musculoskeletal trans-arterial embolisation for the knee (genicular artery embolisation for osteoarthritis / hemarthrosis), shoulder (frozen shoulder), elbow (tennis/golfer’s elbow), foot (plantar fasciitis)

Trauma and Emergencies

• Conditions we treat:
  • Haemorrhage (internal bleeding) - Solid organ injury, Vascular injury (dissection, pseudoaneurysm, rupture), Pelvic injury, Gastrointestinal bleeding (variceal and non-variceal), Haemoptysis, Epistaxis
  • Infection – Abscess, Pleural empyema, Gallbladder infection (cholecystitis)
  • Obstruction – Bile duct obstruction, urinary system obstruction (e.g. stones or cancer), urine leak
• Procedures we perform:
  • Trans-arterial / trans-venous embolisation for bleeding)
  • Thrombin injection of pseudoaneurysm, Vascular stenting, Percutaneous vascular closure
  • Portal hypertension treatment (TIPPS, BRTO, PRTO, variceal embolisation)
  • Biliary drainage and stenting, Percutaneous biliary stone removal, Percutaneous cholecystostomy, Gallbladder sclerotherapy/ablation
  • Percutaneous nephrostomy, Ureteric stent insertion, Ureteric embolisation, Suprapubic catheter insertion
  • Abscess aspiration and drainage, Chest tube insertion, Peritoneal drainage

Men’s and Women’s Health

• Conditions we treat:
  • Men: Enlarged prostate (BPH), Varicocele, Erectile dysfunction (due to poor blood flow),
  • Women: Uterine fibroids, Uterine adenomyosis, Pelvic congestion syndrome, Tubal factor infertility
• Procedures we perform:
  • Men: Prostate artery embolisation (PAE), Varicocele embolisation, Penile artery angiography and angioplasty,
  • Women: Uterine fibroid embolisation (UFE) / Uterine artery embolisation (UAE), Uterine fibroid ablation, Pelvic venous embolisation, Hysterosalpingography (HSG) and Fallopian tube recanalisation (FTR)

Paediatrics

• Conditions we treat: Infantile haemangiomas, Arteriovenous malformations, Venolymphatic malformations, Other conditions common to adults (covered in other sections)
• Procedures we perform: Sclerotherapy, Embolisation, Intralesional therapy

Other Procedures

• Vascular access (short and long term): PICC, Venous port, Central venous catheter (short term and tunnelled), Tunnelled haemodialysis catheter
• Biopsies: Core needle biopsies or fine needle aspiration (FNA) of various sites (head and neck, lymph nodes, soft tissue, lung, solid organs, bone and soft tissue)
• Drainages: Aspiration and drain insertion for fluid collections, Cyst aspiration and sclerotherapy, Pleural and ascites drainage (short and long term), Lumbar puncture / lumbar drain insertion
• Lymphatics: Lymphangiogram, Lymphatic / chyle leak embolisation.
• Enteric access: Percutaneous gastrostomy, Feeding tube insertion
• Air leak embolisation for pneumothorax
• Adrenal venous sampling