Interventional Radiology

and Vascular Lab Services

Interventional Radiologists guide a catheter through the body’s arteries to the site of the medical problem, such as a blockage in an artery in a vessel in the leg. In some cases, the catheter may have tiny instruments attached, which the Interventional Radiologist uses to treat the problem. Thanks to fluoroscopy, ultrasound and other imaging technology, the Interventional Radiologist is able to see, on a monitor, the location of the catheter inside the body and perform intricate procedures with precision accuracy.

Interventional Radiology Procedures being performed at SOCH include

Angiography: Angiography is an X-ray exam of the arteries and veins to diagnose blockages and other blood vessel problems. An interventional radiologist performs this X-ray procedure, which is also called an angiogram. During the angiogram, the doctor inserts a thin tube (catheter) into the artery through a small nick in the skin about the size of the tip of a pencil. A substance called a contrast agent (X-ray dye) is injected to make the blood vessels visible on the X-ray. One of the most common reasons for angiograms is to see if there is a blockage or narrowing in a blood vessel that may interfere with the normal flow of blood through the body. In many cases, the interventional radiologist can treat a blocked blood vessel without surgery at the same time the angiogram is performed.

Balloon Angioplasty and Stent Placement: 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.

Diagnostic Arteriography: An arteriogram allows doctors to view arteries in nearly any area of the body. It’s often one of the first steps the interventional radiologist takes to help diagnose problems and pinpoint treatment areas.  During this procedure the doctor will insert an intravenous (IV) line into a blood vessel in your arm, groin, neck or chest. A thin, hollow tube (catheter) is then inserted into the IV line and guided to the area of concern. A contrasting agent is injected into the blood vessel to make it show up on X-ray.  This minimally invasive technique is one of the most effective ways to view arteries.

Percutaneous nephrostomy tubes: This procedure provides a minimally invasive way to implant a drainage tube into the kidneys.

Radiofrequency Ablation of Liver Tumors: Many methods of minimally invasive therapy have been tried in recent years to eliminate tumors in organs like the liver. One of the most promising is called radiofrequency ablation, sometimes referred to as RFA. A special needle electrode is placed in the tumor under the guidance of an imaging method such as ultrasound or computed tomography (CT) scanning. A current then is passed through the electrode to heat the tumor tissue near the needle tip and ablate—or eliminate—it. The heat from radiofrequency energy also closes up small blood vessels, thereby minimizing the risk of bleeding. In general, radiofrequency ablation causes only minimal discomfort and may be done as an outpatient procedure without general anesthesia. Admission to the hospital is not usually necessary.

Radiologic Thrombolysis: Thrombolysis is the treatment to break up abnormal blood clots that are restricting blood flow. Thrombolytic therapy dissolves these blood clots using various medications administered directly into the clot through a catheter.  Mechanical thrombolysis is the disruption of a blood clot using one of several mechanical devices.

Uterine Fibroid Embolization: Uterine fibroid embolization (UFE) is a new way of treating fibroid tumors of the uterus. Fibroid tumors, also known as myomas, are masses of fibrous and muscle tissue in the uterine wall which are benign, but which may cause heavy menstrual bleeding, pain in the pelvic region, or pressure on the bladder or bowel. With angiographic methods similar to those used in heart catheterization, a catheter is placed in each of the two uterine arteries and small particles are injected to block the arterial branches that supply blood to the fibroids. The fibroid tissue dies, the masses shrink, and in most cases symptoms are relieved.

Vascular Access Procedures: A vascular access procedure is designed for patients who need intravenous (IV) access for a considerable time, longer than seven to 10 days. A simple IV is effective in the short term but is far from ideal when, for instance, a patient needs a course of chemotherapy, several weeks of IV antibiotic treatment or long-term IV feeding. Some patients have veins that make it difficult to place an IV and those patients may benefit from a vascular access placement. A vascular access catheter is a long, thin tube that is placed in a vein in the arm, in the neck or in the chest just beneath the collarbone. The tube then is threaded into a major vein in the middle of the chest. In many conditions, having this type of tube inserted provides a simple and painless means of drawing blood, or delivering drugs, nutrients or both. This also spares the patient the discomfort and stress of repeated needle sticks. These so-called central catheters can remain in place for weeks, months or even years.

Vertebroplasty: This is an image-guided, minimally invasive, nonsurgical therapy used to strengthen a broken vertebra (spinal bone) that has been weakened by osteoporosis or, less commonly, cancer. Vertebroplasty can increase the patient's functional abilities, allow a return to the previous level of activity, and prevent further vertebral collapse. It is usually successful at alleviating the pain caused by a compression fracture. Often performed on an outpatient basis, vertebroplasty is accomplished by injecting an orthopedic cement mixture through a needle into the fractured bone.  A similar procedure, kyphoplasty, is where the original height and angle of kyphosis of a fractured vertebra (of certain types) are restored, followed by its stabilization using injected bone filler material. The procedure is commonly done percutaneously (through the skin). Kyphoplasty is designed to stop the pain caused by the bone fracture, to stabilize the bone, and to restore some or all of the lost vertebral body height due to the compression fracture.

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