Interventional Radiology

What is Interventional Radiology

Interventional Radiology is a subspecialty of radiology which involves procedures relying on the use radiological image guidance (X-ray, fluoroscopy, ultrasound, CT, or MRI) to precisely access the area of therapy. These are minimally invasive procedures as an alternative to open or laparoscopic surgeries. Highly trained Interventional Radiologists perform these procedures in order to utilize their diagnostic image interpretations and manipulated the instruments to the intended area of the body under image guidance. Most of what we do is in an outpatient setting.

Conditions and Procedures

• Liver Cancer
  • • Radioembolization: Delivering radioactive beads directly in the artery feeding the tumors
    • Transcatheter chemoembolization (TACE): Delivering chemotherapy directly in the artery feeding the tumors
    • Cryoablation or thermal ablation: Heating or freezing the tumor with small probes with image guidance through the skin

Kidney Cancer

• • • Cyroablation: Freezing the tumor under image guidance with small needles through the skin

Deep Vein Thrombosis (DVT)

• • • Catheter directed thrombolysis: Dripping a medication that dissolves clot in the veins
    • IVC filter placement: Placement a basket to catch clot from the legs before it goes to the lung. This is done through a tiny catheter
    • Thrombectomy

Varicose Veins

• • • Office based, minimally invasive procedures, as described in the vein section, to eliminate faulty veins

Varicocele

• • • Varicocele embolization: Through tiny catheters the refluxing gonadal vein causing the pain or infertility is occluded

Pulmonary embolism (PE)

• • • Catheter directed thrombolysis or thrombectomy. In the acute setting of PE catheters can be used to install medication to dissolve the clot or suck the clot out

Fibroids

• • • Uterine artery (or fibroid) embolization (UAE or UFE): Patient with symptomatic uterine fibroids can be treated without surgery in an outpatient setting. Catheters are used to access the uterine artery and deliver little beads to block the blood flow and shrink the fibroids

Osteoporosis-Kypho/Vertebroplasty

• • • In the setting of compression fractures of the spine, stabilization and pain control can be achieved with injection of cement in to the fracture from needles from the skin.

Pelvic Congestion Syndrome (PCS)

• • • Must like the varicose veins in the legs, varicose veins can develop in the pelvis and cause significant and bleeding. Via a catheter these veins can be occluded as an outpatient

Chronic liver disease (cirrhosis)

• • • Transjugular intra-hepatic portal-systemic shunt (TIPS): In patient with cirrhosis and chronic liver disease a (TIPS) can be placed to alleviate ascites, pleural effusion, or gastroesophageal bleeding

Peripheral Arterial Disease (PAD)

• • • Angioplasty (ballooning), stenting, or atherectomy (plaque removal) can be done as an outpatient to improve blood flow to the legs

Renovascular (renal) hypertension

• • • Stenting of the kidney arteries in the setting of high blood pressure caused by narrowing of the kidney arteries

Congenital Vascular Malformations

• • • Sclerosing or embolization of the abnormal vessels in the vascular malformations

Arteriovenous malformations(AVM)

• • • Embolization of the AVMs with small catheters

Hemodialysis fistula maintenance and dialysis central access

• • • Long term or short term access to the central veins for Hemodialysis
    • Angioplasty or stenting of narrowing of the dialysis fistulas
    • Declot

Feeding tube placement

• • • Gastrostomy tube placement: In patients with feeding issues a G-tube or GJ-tube can be placed through the skin as an outpatient or inpatient

Kidney stones and stent placement

• • • Nephrostomy tube placement: A tube through the skin can be placed into the kidney to drain the kidney with obstruction from a stone or other reasons. Access can also be used to remove the stone.

Prostate Artery Embolization (PAE)

• • • For patients with urinary symptoms related to an enlarged prostate (BPH), this procedure can be performed to cut off the blood supply to the prostate. This leads to shrinking of the prostate and improvement in symptoms.

CSF Leak Treatment

• • • A small amount of the patient’s blood is injected into the spinal column near the leak. This blood will form into a patch to help stop the CSF leak.

Celiac Plexus Ablation

• • • This treatment, and other nerve oblation procedures help reduce pain in the body. These are especially effective in cases of chronic pain. Normal procedure includes an injection of an alcohol-like substance that destroys the nerves in the affected area, and helps relieve the brain and body of the pain signals that are being sent from there.