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Minimally Invasive Interventional Procedures

Minimally Invasive Interventional Procedures

Interventional procedures include interventional endoscopy, interventional radiology, cardiac interventions and other image-guided procedures which allow a minimally invasive approach to treatment of a variety of conditions. The procedures usually use some combination of fluoroscopy, endoscopy and ultrasound, via percutaneous access or through natural body orifices, to access an area of the body and deliver a specific treatment.

These procedures are often treated with a multi-disciplinary approach involving clinicians from the internal medicine, cardiology, diagnostic imaging, and surgery teams.

Willows has a wide range of equipment and expertise allowing us to offer a number of these procedures. The cardiology team at Willows are the most experienced interventional cardiology team in the UK. In addition, Andrew Kent, one of our internal medicine Specialists, has completed significant additional training in interventional procedures, both in the USA and with human interventionalists in the UK. He has particular interests in endourology, respiratory and gastrointestinal procedures, and is the only clinician in the UK performing endoscopic biliary interventions. Chris Shales, one of our soft tissue surgery Specialists, has also undergone additional training in interventional radiology as well as being a hugely experienced soft tissue surgeon. Our orthopaedic team have over 15 years’ experience in arthroscopic treatment of several different joint conditions.

Examples of some of the procedures we offer are listed below, however the range of procedures is evolving all the time, and so should you have any queries about whether an interventional procedure may be appropriate for your pet or client then please don’t hesitate to contact one of our Specialists for advice.
 

Cardiology:

  • Interventional treatment of patent ductus arteriosus (PDA)
    • Amplatz Canine Duct Occluder (ACDO) for 2.5kg to 100kg 
    • Coil occlusion
    • Amplatzer plug for dogs < 3kg
  • Balloon dilatation
    • Valvular pulmonic stenosis
    • Sub-aortic stenosis with cutting balloon 
    • Cor triatriatum dexter
    • Other obstructive vascular diseases
  • Pacemaker Implantation
    • Transvenous 
    • Epicardial
  • Percutaneous Medtronic Reveal linq loop recorder (implantable event recorder for intermittent arrhythmias).

ACDO advancement and deployment

ACDO release
 

Valvular pulmonic stenosis

Valvular pulmonic stenosis

Pacemaker implantation

Pacemaker implantation

 

Respiratory:

  • Balloon dilatation or stenting for nasopharyngeal stenosis
  • Tracheal stenting for drug-refractory tracheal collapse or other obstructive diseases
  • Endoscopic debridement and minimally invasive treatment of sinonasal aspergillosis
     
Endoscopic and radiographic  views of a  tracheal 
stent placed for treatment of  collapsing  trachea

Endoscopic and radiographic views of a tracheal stent placed for treatment of collapsing trachea

Fluoroscopic placement  of 
a tracheal  stent

Fluoroscopic placement of a tracheal stent
 
 

Radiographic view of a  tracheal 
stent placed for treatment of  collapsing  trachea

 

Nasopharyngeal Stenosis

Nasopharyngeal Stenosis

 

Urology/Nephrology:

  • Ureteral stent placement for benign or malignant obstructions (cystoscopic in dogs and female cats, surgical in male cats)
  • Laser ablation of ectopic ureters 
  • Laser polypectomy
  • Laser debulking of tumours
  • Urethral stent placement 
  • Percutaneous cystostomy tubes for management of urethral obstruction
  • Subcutaneous ureteral bypass placement
  • Percutaneous perineal approach for male cystoscopy 
  • Cystoscopic injection of urethral bulking agents for urinary incontinence 
  • Sclerotherapy for drug-refractory renal haematuria
  • Percutaneous antegrade urethral catheterisation for difficult obstructions
     
Ectopic ureteral opening mid urethra

Ectopic ureteral opening mid urethra


Laser ablation

Laser ablation

Laser ablation

Laser ablation

Abdominal Radiograph with stent

Abdominal Radiograph with ureteral stent

 

Gastrointestinal:

  • Management of oesophageal strictures
    • Balloon dilatation
    • Balloon-oesophagostomy tube
    • Oesophageal stent placement
  • Endoscopic polypectomy (upper and lower GI)
  • Endoscopic clipping of bleeding gastric ulcers
  • GI stenting for stenosis or obstructive neoplasia
  • Endoscopic biliary procedures:
    • Biliary stents
    • Removal of stones
    • Sphincterotomy
    • ERCP
Oesophageal stricture before

Oesophageal stricture before

Oesophageal stricture during ballooning

Oesophageal stricture during ballooning

 

Vascular:

  • Transvenous coil embolisation of intrahepatic portosystemic shunts
  • Vascular stenting for obstructive neoplastic disease
  • Embolisation (and chemoembolisation) of unresectable tumours
     
Willows’ Specialists have unsurpassed expertise in  shunt surgery

Willows’ Specialists have unsurpassed expertise in shunt surgery

Porto-azygous  shunt - subtraction  fluoroscopy after contrast injection

Portosystemic shunt - subtraction fluoroscopy after contrast injection

 

Laparoscopy

  • Laparoscopic-assisted procedures, e.g. cystotomy.
  • Cholecystectomy
  • Elective ovariectomy and cryptorchidectomy
  • Liver biopsy
Laparoscopic  liver 
biopsy

Laparoscopic liver biopsy

Laparoscopic orchidectomy

Laparoscopic orchidectomy

 

Thoracoscopy:

  • Exploration and biopsies
  • Pericardectomy 
  • Lung lobectomy 
  • Thoracic duct ligation 
  • Mass resections
     
Laparoscopic  liver 
biopsy

Thorascopic pericardiecetomy

Laparoscopic orchidectomy

Thorascopic pericardiecetomy

 

Arthroscopy:

  • Detailed intra-articular joint examination
  • Biceps tendon release for bicipital tenosynovitis
  • Minimally invasive treatment for elbow dysplasia including fragment removal and sub-total coronoidectomy
  • Arthroscopic assessment of the cranial cruciate ligament and the menisci for early diagnosis of cranial cruciate ligament deficiency
Arthroscopy  at  Willows

Arthroscopy at Willows

Bicipital  tenosynovitis  in
a  Labrador  Retriever

Bicipital tenosynovitis in a Labrador Retriever

Oncology:

  • Tumour ablation
  • Transarterial embolisation and chemoembolisation
  • Stenting of malignant obstructions, e.g. urethra, oesophagus, rectum

 

 

 

 

 

 

if you wish to discuss these procedures or would like further information please contact one of our clinicians from the relevant discipline: internal medicine, cardiology, diagnostic imaging, surgery and oncology teams on 0121 712 7070 who will be happy to help.