Sir Ganga Ram Hospital, New Delhi, India

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Interventional Radiology

 

Chairperson and Senior Consultant: Dr Arun Gupta
Consultant: Dr Ajit Yadav
Associate Consultant: Dr Raghav Seth

 

ORGANOGRAM

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SERVICES & INNOVATIVE TREATMENTS OFFERED

 

Interventional Radiology utilizes minimally invasive procedures that are image-guided, to diagnose as well as treat patients in nearly every organ system. These procedures have less pain, minimal complication rate and less recovery time in comparison to open surgery.

The Department of Interventional Radiology was established in 2006, at Sir Ganga Ram Hospital by Dr. Arun Gupta. Our department is well developed with our own IR OPD and IR Angio-Suite (Cath Lab). All in-patients who undergo any kind of IR procedure are monitored daily, during morning and evening rounds.

Innumerable non-vascular procedures including FNACs, Biopsies, Percutaneous drainages (PCD) are carried out both on OPD and on in-patient basis. In addition, PTBD (Percutaneous Trans hepatic Biliary Drainage), Biliary Stenting, stone removal (Hepaticolith), PCN (Percutaneous nephrostomy) and Ureteral Stenting are also performed commonly under local anesthesia or sedation.

As far as vascular procedures are concerned, all kinds of Embolization: BAE (Bronchial Artery Embolization for hemoptysis (coughing of blood), Renal Bleed Embolization & GI (gastro intestinal) bleed embolization are performed commonly. Basically, these are the procedures to stop/control bleeding from the concerned site and are thus carried out on emergency as well as elective basis.

We are also one of the very few centers that perform lymphangiography and thoracic duct embolization for lymphatic leaks.

Stenting for bowel ischemia, peripheral arterial & venous disease and TIPSS (Trans jugular intrahepatic portosystemic shunt) for recurrent and non-resolving ascites or hematemesis (vomiting of blood) are also carried out commonly by our team.

Obstetric & gynecological procedures including UAE (Uterine Artery Embolization) for Fibroids / adenomyosis and PPH (excessive bleeding after delivery) are also performed by our team. We also offer treatment options for infertility including Fallopian tube sclerotherapy for hydrosalpinx before IVF and varicocele embolization.

Oncological Interventions are an important part of our department. We perform pre-operative embolization for a variety of tumors along with Trans-arterial chemo and radioembolization (TACE/TARE) for liver tumors- HCC and hepatic metastasis. Percutaneous ablation of liver tumors, bone tumors and thyroid nodules is also performed routinely, using MWA (microwave ablation) and RFA (radio-frequency ablation).

The new procedures that have been started recently in our department include PAE (prostatic artery embolization) for BPH (benign prostatic hyperplasia) and GAE (genicular artery embolization) for pain due to osteo-arthritis and ablation for thyroid nodules.

Recently, we have started performing musculoskeletal (MSK) interventions including pain management and minimally invasive interventions for sports injury. These include interventions for spinal pain (disc prolapse, facet arthropathy), vertebroplasty for vertebral collapse, joint and soft tissue injections (including PRP) for common diseases like osteoarthritis, Rotator Cuff tear/tendinopathy, Lateral epicondylitis (Tennis Elbow), Carpal Tunnel Syndrome, tendon tears, Achilles tendinopathy and plantar fasciitis. We also perform image guided nerve blocks, treatment for headache and cancer related chronic pain.

Training (fellowship) of interventional radiology residents had been started in our department in 2013. In addition, DNB super-specialization (DNB-SS) in IR (Interventional Radiology) was started for the first time in Gangaram Hospital in our department, from 2019.

Our team consists of renowned, dedicated & well-trained doctors including Dr. Arun Gupta - Chairperson & senior consultant, Dr. Ajit Yadav - Consultant and Dr. Raghav Seth - Associate Consultant, along with Fellows, DNB registrars and Senior Residents (Dr. Darshan Thummar, Dr Santosh Joshi, Dr Vinith Kurki and Dr Ujjwal Agarwal). Regular academic sessions including seminars, journal clubs & case discussions are carried out in the department (thrice a week).

Our department is also involved in academic research & we have multiple publications in national & international journals. IR procedures have become an integral part of medical care with IR Physicians increasingly taking on a clinical role. We hope to expand & develop the department further.

 

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Achievements

 

Publications (2019-22)
  • Seth R, Gupta A, Yadav A. Management of Bleed from Percutaneous Portal Puncture Site (post-BRTO) by Trans-jugular-Trans-Hepatic Embolization. Journal of Clinical Interventional Radiology ISVIR. 2021 Nov 12.
  • Seth R, Yadav A, Gupta A. Glue embolization of accessory renal artery pseudo-aneurysm & AVF post-PCNL. African Journal of Urology. 2021 Dec;27:1-3.
  • Yadav A, Seth R, Gupta A. Microwave Ablation of Spinal Osteoid Osteoma—Role of Air Insulation. Journal of Clinical Interventional Radiology ISVIR. 2022 Feb 25.
  • Gupta A. SMA Stenting in Fibromuscular Dysplasia: Positive outcome After Intervention. EURORAD [Internet]. 2022 Aug 31; Available from: https://www.eurorad.org/case/17866
  • Singla V, Yadav AK, Arora A, Gupta A. Permanent External Biliary Catheter: A Difficult Problem Managed by Rescue Technique of Hepatico-cholecysto-gastrostomy. Journal of Digestive Endoscopy. 2021 Mar;12(01):054-5.
  • Pathak A, Shrestha MK, Khanna S, Nanavati JD, Prasad OP, Gupta A, Mistry T. Contemporary management of prostatic abscess: Our experience. Urology Annals. 2022 Apr;14(2):135.
  • Narkhede A, Yadav AK, Gupta A. N-Butyl Cyanoacrylate Embolization in Management of Iatrogenic Renal Hemorrhages—Single-Center Study Evaluating Safety and Efficacy. Journal of Clinical Interventional Radiology ISVIR. 2022 Aug;6(02):075-82.
  • Seth R, Gupta A, Yadav A. Lymphangiography and thoracic duct embolization (both antegrade and retrograde approaches) in a case of spontaneous chylous leak after failed thoracic duct ligation. Journal of Vascular Surgery Cases, Innovations and Techniques. 2022 Dec 1;8(4):779-80.
  • Mahendra KM, Gangwani G, Yadav A, Gupta A. Treatment of early hepatic venous outflow obstruction after living donor-related liver transplantation by the insertion of expandable metallic stent. Indian Journal of Transplantation. 2019 Jan 1;13(1):65.
  • Narkhede A, Yadav A, Malik M, Shrestha MK, Gupta A. Delayed PresentationofRenal Arterio-VenousFistula and Pseudoaneurysm in Native Left Kidney in Allograft Recipient: A Case Report. JNMA: Journal of the Nepal Medical Association. 2019 Aug;57(218):263.
  • Shreshta MK, Narkhede A, Gupta A. Antegrade Double-J Stenting in Grossly Dilated and Tortuous Ureters. Journal of Clinical Interventional Radiology ISVIR. 2020 Aug;4(02):125-9.
  • Gupta A, Narkhede A, Yadav AK. Vascular Complications after Hepatic Transplantation: Role of Interventional Radiology in Management. Basics of Hepatobiliary Interventions. 2021:217-33.
  • Yadav A, Jain Y, Narkhede A, Mahendra KM, Gupta A. Lymphangiography and Lymphatic Interventions. Journal of Clinical Interventional Radiology ISVIR. 2021 Apr;5(01):29-38.
  • Kalia S, Narkhede A, Yadav AK, Bhalla AK, Gupta A. Retrograde transvenous selective lymphatic duct embolization in post donor nephrectomy chylous ascites. CEN Case Reports. 2022 Feb:1-5.

 

Oral presentations and Posters

 

  • E-Poster- 23rd Annual Conference of Indian Society of Vascular and International Radiology, Hyderabad (09-12 February 2023)

2nd prize non vascular intervention E-poster: Safe to Unsafe" - Bleeding after paracentesis : Presentation and management

  • Oral Presentation- 23rd Annual Conference of Indian Society of Vascular and International Radiology, Hyderabad (09-12 February 2023)

2nd prize non vascular intervention: "Burn the problem" - Initial experience of Thermal ablation for benign thyroid nodules

  • Oral Presentation, Scientific Abstract, September 11 2022, CIRSE 2022, Barcelona, Spain

Comparison of effectiveness & safety of embolic agents-PVA versus n-butyl-2-cyanoacrylate in bronchial artery embolization for control of haemoptysis

  • Oral Presentation, 20-21 August 2022 , ISVIR Mid-term CME Complication Management, Mumbai

Management of bleed from Percutaneous Portal Puncture Site (post-BRTO) by Trans-jugular-Trans-Hepatic Embolization

  • Oral Presentation, 20-21 August 2022 , ISVIR Mid-term CME Complication Management, Mumbai

Post-Embolization Rupture of Renal Angiomyolipoma into Liver

  • Oral Presentation, Delhi state chapter of ISVIR, 25th September 2021

Curious case of chylous leak

  • Oral Presentation- 23rd Annual Conference of Indian Society of Vascular and International Radiology, Hyderabad (09-12 February 2023)

Ultrasound guided Percutaneous Parotid duct Access In Sialolithiasis

  • Oral Presentation- 23rd Annual Conference of Indian Society of Vascular and International Radiology, Hyderabad (09-12 February 2023)

Lymphangiography and Thoracic Duct Embolization for treatment of lymphatic leaks: A 4-year Experience from a Tertiary Care Hospital

 

Faculty

 

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Dr. Arun Gupta

  • MBBS, MD, EBIR
  • Chairperson and Senior Consultant, Department of Interventional Radiology
  • Immediate Past Secretary, ISVIR

Dr. Arun Gupta did his Master's in Radio Diagnosis from Ganesh Shanker Vidyarthi Medical (GSVM) College, Kanpur in 2002. He pursued super-specialization training during his Senior Residency (SR) in Interventional Radiology from Sanjay Gandhi Post Graduate Institute (SGPGI), Lucknow till 2005.

In 2006, he joined Sir Ganga Ram Hospital as a Consultant and established the Department of Interventional Radiology and presently is the Chairperson of the Department at the hospital. Under the capable leadership of Dr. Arun Gupta, the Department of Interventional Radiology, Sir Ganga Ram Hospital has reached new heights and continuously working for the advancement and the meteoric rise of the department.

Dr. Gupta is an international figure and a key opinion leader in the country in the field of Interventional Radiology with numerous International and National paper publications, and paper presentations and has taken national as well as international guest lectures. He is the Vice-President of the Indian Society of Vascular and Interventional Radiology and a Member of the Asia Pacific Society of Cardio-Vascular Interventional Radiology.

Dr. Arun Gupta has a special academic interest in the Management of Hepatocellular Carcinoma and has one of the largest experiences in the country on Trans-arterial Chemo Embolization and has done a lot of research in this field. He also has one of the largest series of embolization for the management of Hepatic Artery Pseudo-aneurysms. He is the First to perform Percutaneous Hepatic-gastrostomy in the case of Portal Biliopathy all over the world.

He has excellent organizational skills and is involved in all academic and clinical activities of the department. He is a visually oriented person with the highest professional standards and has contributed largely to the development and recognition of Interventional Radiology in India. He also has established a comprehensive training program for Interventional Radiologists which can be implemented across the country to enhance patient care. He also wants to create an environment where healthcare costs can be reduced and treatment for diseases can be made more affordable to the masses.

 

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Dr. Ajit Yadav

  • MBBS, DNB, FVIR, EBIR
  • Consultant, Department of Interventional Radiology
  • Secretary, ISVIR; President Elect, IRIA Delhi

Dr. Ajit K Yadav is a consultant at the Department of Interventional Radiology, Sir Gangaram Hospital, New Delhi. After receiving a medical degree at the Pt BDS PGIMS, Rohtak, he served as a medical officer at a rural government hospital for 6 months. He completed residency training in radiodiagnosis at Sir Gangaram Hospital. He was nationally board-certified in 2011 and went on to complete a fellowship in Interventional Radiology at GRIPMER, Delhi. He also visited MD Anderson cancer center, in Houston, Texas, USA for a short-term fellowship in 2013. He attended a short training program on TACE at Seoul National University Hospital, South Korea in 2014. Dr. Yadav’s clinical interests include uterine artery embolization for minimally invasive treatment of uterine fibroids and post-partum hemorrhage, prostatic artery embolization for BPH, Bronchial artery embolization for hemoptysis, minimally invasive oncologic interventions (including transarterial chemoembolization, radioembolization, and radiofrequency tumor ablation), ablation for thyroid nodules, and lymphatic interventions. In addition, he offers minimally invasive procedures for various diseases like Varicose veins, Liver diseases, and traumatic bleeding.

His research interests include the interventional treatment of liver malignancy, a topic on which he has written peer-reviewed publications. He has authored more than 30 papers in the field of interventional radiology. He has also presented his work at numerous national and International meetings. In addition to clinical activities, he is an active teacher of residents including Interventional Radiology fellows.

He is a member of several professional organizations, Indian Radiological and Imaging Association (IRIA), the Indian Society of Vascular and Interventional Radiology (ISVIR), and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE). Currently, he is the secretary of ISVIR and President Elect of IRIA Delhi.

 

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Dr. Raghav Seth

  • MBBS (MAMC), MD (PGI Chandigarh), DNB, FVIR (SGRH)
  • Specialized in MSK, Sports Injury & Pain Management Interventions (France)
  • Associate Consultant, Department of Interventional Radiology

Dr. Raghav Seth is an Associate Consultant at the Department of Interventional Radiology, Sir Gangaram Hospital, New Delhi. After receiving a medical degree from the prestigious Maulana Azad Medical College, he completed his Radiology residency at the Institute of National Importance- PGI Chandigarh. Subsequently, he was certified as a Diplomat of the National Board & completed his fellowship in Interventional Radiology from Sir Gangaram Hospital, Delhi.

Further, he went on to complete training in Musculoskeletal (MSK), Sports Injury & Pain Management Interventions, at the University of Strasbourg, France, under the guidance of the world-renowned pioneer of musculoskeletal Interventions (Prof Gangi). His clinical interests include Vertebroplasty for vertebral collapse (osteoporotic or metastatic), spinal infiltrations-epidural and foraminal for disc herniation-related nerve compression, facet joint blocks, and Rhizolysis for facet joint arthropathy-related pain, all kinds of nerve blocks, soft tissue & joint injections (steroid/Visco/PRP).

Apart from these, Dr Raghav Seth is also interested in various non-vascular interventions like image guided FNACs/biopsies, percutaneous drainages (PCD), PCN, PTBDs as well as vascular interventions like Prostatic artery embolization (PAE), Uterine artery embolization (UAE), varicoele embolization, Bronchial artery embolization (BAE), Embolization for gastrointestinal and renal bleeds and other minimally invasive oncologic interventions (including trans-arterial chemo & radio embolization- TACE/TARE, and tumor ablation-microwave ablation-MWA and radiofrequency ablation-RFA).

His research interests include Musculoskeletal and pain management interventions along with other vascular interventions, to which he has contributed multiple peer-reviewed publications. He has also presented his work at numerous national and International conferences including IRIA, ISVIR, ET (France), and CIRSE 2022 (Spain).

He is a member of several professional organizations including the Indian Radiological and Imaging Association (IRIA), the Indian Society of Vascular and Interventional Radiology (ISVIR), and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).