About Interventional Radiology? 

Interventional Radiology is a medical specialty that has been called "The Surgery of the 21st Century."   Just like other medical specialists interventional radiologists are physicians who have many years of special training after medical school. This training includes the use of X-rays as well as  other imaging techniques (radiology) that "see" inside the body.   These physicians also undergo extensive training in techniques that treat diseases percutaneously (through the skin). 

Using radiologic images to guide their procedures, Interventional Radiologists insert thin tiny tubes called catheters and other tiny instruments through the blood vessels and other pathways of the body to treat a wide variety of conditions that once required surgery.

These procedures often eliminate the need for patients to undergo more traditional surgery since they are safer and less costly.  This allows the patient to quickly recuperate at home and resume their daily activities.

How small is small?

Interventional Radiologists make a small nick in the skin and insert their tiny instruments through it   But how small is small?  Remarkably, most incisions are no larger that the lead tip of a pencil!  The Interventional Radiologist  guides a thin tube (catheter) and tiny, fine instruments to the site of a problem. The Interventional Radiologist then fixes the problem and removes the catheter and instruments. Stitches generally are not needed, and procedures rarely require general anesthesia.

 

Patient Care

Interventional Radiologists admit patients to the hospital and have the necessary clinical care skills to manage each patient's care. Interventional radiologists work closely with the patient's primary care physician and Vascular Surgeons to be sure the patient receives the best possible care.

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Advantages of Interventional Radiology:

• Risk, pain, and recovery time are significantly reduced in many cases.

• Many procedures can be performed without an overnight stay in the hospital.

• General anesthesia is usually not required.

• Procedures are often less expensive than the surgical alternatives.

SOURCE:    SOCIETY OF INTERVENTIONAL RADIOLOGY

Angiography -- an X-ray exam of the arteries that uses a catheter to enter the artery and a contrast agent (X-ray dye) injection that makes the artery visible on the X-ray.

Balloon Angioplasty -- opens blocked or narrowed blood vessels.  In this technique, the interventional radiologist inserts a very small balloon attached to a thin tube (catheter) into a blood vessel through a small nick in the skin.   The catheter is threaded under X-ray guidance to the site of the blocked artery.   The balloon is inflated to open the artery.  Sometimes, a small metal scaffold / tube, called a stent, is inserted to hold the blood vessel open.

 

Chemoembolization -- delivery of cancer-fighting agents directly to the tumor site

Central Venous Access Catheters (CVAC) and Gastrostomy (Feeding) Tubes

People with certain diseases or medical conditions sometimes require that tubes be placed into the body so that they can receive medications or nutrients directly into the blood stream or gastrointestinal system, or so blood can be drawn.  Once, surgery was required to insert these tubes, but today these procedures can be done without surgery by an interventional radiologist.

Needle Biopsy -- diagnostic test for breast or other cancers that is an alternative to surgical biopsy.

Ovarian Vein Embolization -- a treatment for "varicose veins" in the ovary - a cause of pelvic pain.

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TIPS -- (transjugular intrahepatic portosystemic shunt) - improves blood flow for patients with severe liver dysfunction.

Vena Cava Filters -- prevents blood clots (pulmonary emboli) from reaching the lungs.

Varicocele Embolization -- a treatment for "varicose veins" in the testicles - a common cause of male infertility.

Vascular Embolization -- a technique to treat bleeding from injured blood vessels.

Fallopian Tube Catheterization -- opens blocked fallopian tubes, a common cause of female infertility.  The most common cause of female infertility is a blockage of the fallopian tube through which eggs pass from the ovary to the uterus.  Occasionally, these tubes become plugged or narrowed, preventing successful pregnancy. Interventional radiologists can diagnose and treat a blockage in the fallopian tubes with a nonsurgical procedure known as selective salpingography. In the procedure, which does not require an incision, a thin tube (catheter) is placed into the uterus. A contrast agent, or dye, is injected through the catheter, and an X-ray image of the uterine cavity is obtained. When a blockage of the fallopian tube is identified, another catheter is threaded into the fallopian tube to open the blockage.

Thrombolysis -- dissolves blood clots by the administration of medications into the clot.This treatment is used if the blockage in an artery is caused by a blood clot. Thrombolytic drugs that dissolve clots are injected through a catheter to eliminate the clot and restore blood flow.

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Male Infertility: Treatment for Varicoceles

Varicoceles -- tangled blood vessels, or varicose veins, in the testicles is a major cause of male infertility. Interventional radiologists treat varicoceles without surgery with a procedure known as varicocele embolization. A thin tube (catheter) is threaded through a small nick in the skin and into the affected vein in the testicle. An embolization agent -- either a drug, a small balloon or tiny metal coils -- is injected through the catheter to block off the varicocele. The swollen vessel shrinks, often resolving the infertility problem.

Interventional Treatments for Liver Disease

There are a number of problems in the liver that can be treated with nonsurgical, interventional radiology techniques.

Portal Hypertension 

Seen most frequently in patients with liver disease such as cirrhosis or hepatitis, portal hypertension is a condition in which the normal flow of blood through the liver is slowed or blocked by scarring or other damage. Patients with the condition are at risk of internal bleeding or other life-threatening complications.

Interventional Radiologists treat portal hypertension without surgery, using a procedure called TIPS (transjugular intrahepatic portosystemic shunt). The doctor threads a thin tube (catheter) through a small incision in the skin near the neck and guides it to the blocked blood vessels in the liver. Under X-ray guidance, the doctor creates a tunnel in the liver through which the blocked blood can flow. The tunnel is held open by the insertion of a small metal cylinder, called a stent.

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