Procedures – Interventional Radiology
Contact us today to learn more about our Interventional Radiology Procedures.
Procedures – Interventional Radiology
Contact us today to learn more about our Interventional Radiology Procedures.
Interventional Radiologists specialize in minimally invasive procedures using image-guidance for the treatment of medical conditions that once required surgery. By harnessing the power of advanced imaging – ultrasound, fluoroscopy (real time X-rays), CT and MRI scans – Interventional Radiologists can see inside your body and treat complex conditions less invasively and with unprecedented precision. This reduces length of stay in the hospital, minimizes potential complications and saves lives. While all of our Radiologists perform basic procedures, our fellowship-trained Interventional Radiologists specialize in more complex procedures.
Vertebral Fractures - Kyphoplasty
Kyphoplasty and Vertebroplasty are minimally invasive procedures used to treat painful compression fractures in the spine, commonly caused by osteoporosis. The procedure involves injecting cement into the fractured bone through a needle. Sacroplasty is a similar procedure used to treat sacral insufficiency fractures.
- Chemoembolization is a procedure where chemotherapy and small embolic agents are injected directly into blood vessels feeding the tumor to block the blood supply to the tumor and trap the chemotherapy within the tumor.
- Radioembolization is a procedure where small radiation beads are injected directly into blood vessels feeding the tumor to deliver high dose radiation to the tumor while sparing normal liver tissue.
- Microwave ablation is a procedure where a small needle is placed through the skin directly into the liver tumor using image guidance. The tip of the needle is heated up, creating a spherical or ovoid ablation zone which kills the tumor cells.
Interventional Radiologists offer minimally invasive treatments for kidney tumors.
- Cryoablation is a procedure where a small needle is placed through the skin directly into the kidney tumor using image guidance. The tip of the needle is cooled intensely, creating a spherical or ovoid ablation zone freezing and killing the tumor cells.
- Microwave ablation is a procedure where a small needle is placed through the skin directly into the kidney tumor using image guidance. The tip of the needle is heated up, creating a spherical or ovoid ablation zone which kills the tumor cells.
Interventional Radiologists offer a minimally invasive treatment for lung tumors.
- Microwave ablation is a procedure where a small needle is placed through the skin directly into the lung tumor using image guidance. The tip of the needle is heated up, creating a spherical or ovoid ablation zone which kills the tumor cells.
Port Catheter Placement
Interventional Radiologists are experts in placing port catheters. Insertion of a port catheter requires a skin incision about 1 inch in length. The port and tubing are all placed under the skin, the port is placed just below the clavicle, the tubing goes into a neck vein. The procedure is usually performed with moderate sedation and done within 30 minutes.
Uterine Fibroid Embolization
Uterine Fibroids are non-cancerous tumors common in pre-menopausal women. Fibroids can be asymptomatic, but can also cause pelvic pain, heavy menstrual bleeding, and bulk symptoms. Uterine Fibroid Embolization is a minimally invasive procedure where small particles are injected directly into blood vessels supplying the fibroids, blocking their blood supply, and causing them to shrink.
Deep Vein Thrombosis
Deep Vein Thrombosis (DVT) is a blood clot that forms in the deep veins of the leg. Common initial presenting symptoms can include leg pain, warmth, and swelling. These types of blood clots can be problematic as they can dislodge and travel to the heart or lungs (known as pulmonary embolism). Also, if left untreated they can in some cases lead to problems with chronic leg pain and swelling. Although most commonly treated with blood thinning medication (anticoagulation), in severe cases these blood clots require more advance therapies which can include direct administration of clot busting medication (tPA) through a catheter or mechanical fragmentation and removal with special devices.
A pulmonary embolism (PE) is a specific type of blood clot which travels from deep veins elsewhere into the body and becomes trapped in the arteries of the lung where it can disrupt oxygen supply. Common presenting symptoms can include chest pain, leg swelling, and shortness of breath. Mild cases require treatment with blood thinning medication (anticoagulation) and sometimes IVC filter placement. However, in severe cases there are now several newer treatment options available which can include direct delivery of clot dissolving medication (tPA) through a catheter or mechanical disruption and aspiration of clot directly from the pulmonary artery.
IVC Filter Placement and Removal
Inferior Vena Cava (IVC) filter placement is a procedure which involves placement of a small metallic mesh device into the main abdominal vein (IVC) in order to prevent blood clots from traveling from the lower extremities or pelvis into the heart and lungs. This procedure involves a small incision in either the neck or groin where the device is placed through a catheter and positioned appropriately within the IVC using fluoroscopic guidance. Although some patients require permanent IVC filter placement, modern IVC filters are also designed to be retrieved when clinically appropriate.
Dialysis Access Management
In patients with kidney failure the kidneys can no longer filter the blood and make the appropriate amount of urine. For patients with kidney failure, dialysis must be performed to filter the blood in place of the kidneys. In order for dialysis to be performed, venous access (access to the blood vessels) must be established and maintained. Special IV catheters known as dialysis catheters offer a reliable means for patients to receive both short and longer term dialysis treatments. Dialysis catheters are usually placed through the large (jugular) veins in the neck with the tip of the catheter deeper in the chest near the heart. Longer-term dialysis catheters are placed just beneath the skin’s surface along the upper chest where they can be easily hidden underneath clothing and stay in place for weeks to months at a time. Dialysis catheters can sometimes become clogged and require a replacement procedure. Dialysis catheters that are no longer needed can be removed with a simple outpatient procedure. Placement of dialysis catheters is minimally invasive and is typically performed under guidance of both ultrasound and x-ray on an outpatient basis.
Feeding Tube Placement
Feeding tube placement, also known as percutaneous gastrostomy tube (PEG) placement is performed for patients who have persistent swallowing difficulties and are unable to take food or water by mouth. This procedure involves placing a feeding tube through the skin directly into the stomach in order to bypass the mouth and esophagus. Patients can then receive fluid, nutrition and medication directly into the gastrointestinal tract.
A varicocele is an abnormally swollen vein occurring in the scrotum which is similar to varicose veins that form in the leg. Common presenting symptoms can include pain, heaviness, swelling and in severe cases testicular atrophy and infertility. Varicocele embolization is a minimally invasive treatment option which involves the placement of a catheter into the varicocele and delivery of coils, sclerosant or other materials in order to stop flow (embolize) the varicocele and direct blood flow towards other healthy veins.
Pelvic Congestion Syndrome
Pelvic congestion syndrome is a potential cause of chronic lower abdominal and pelvic pain which can occur due to abnormal dilatation of ovarian and uterine veins in the pelvis. Common symptoms can include chronic dull and aching pelvic pain which can sometimes occur in association with varicose veins in the vulva or upper thigh. Treatment for pelvic congestion syndrome involves placement of a catheter into the dilated veins and delivery of coils, sclerosant or other materials in order to stop blood flow (embolize) the veins and direct blood flow towards other healthy veins.
- Cirrhosis is the result of chronic liver disease in which scar tissue replaces normal liver tissue. The symptoms of cirrhosis include abnormal fluid accumulation in the abdomen, abnormal fluid accumulation in the lungs, and abnormal increase in the size of veins in the stomach, esophagus, and abdominal wall. Abnormally dilated veins in the esophagus and stomach can rupture and result in life threatening bleeding events. Abnormal fluid accumulation in the abdomen and chest can result in pain, difficulty breathing, loss of appetite, poor appetite, and risk of serious infection. Cirrhosis can also result in abnormal accumulation of ammonia in the blood resulting in a specific type of confusion called “hepatic encephalopathy”. Cirrhosis causes these symptoms due to increased portal venous pressure (portal hypertension), or increased pressure in the veins that carry blood to the liver from the stomach and intestines returning to the heart. If left unmanaged, cirrhosis and portal hypertension can result in severely limited quality of life and even death.
- A TIPS procedure is a minimally invasive procedure which uses X-ray guidance to place a small tube (stent) through the scar tissue in the liver to connect two veins in order to “shunt” blood through the liver and lower portal venous pressure. The TIPS shunt and resultant decrease in portal venous pressure can decrease the risk of bleeding in the stomach or esophagus and decrease or eliminate the amount of fluid build up in the abdomen and lungs. The procedure represents a good option to treat the symptoms of cirrhosis/portal hypertension in a patient who is evaluated as a safe candidate for the procedure.
Tunneled Pleural or Peritoneal Catheters
- Ascites is the abnormal accumulation of fluid in the abdomen. Pleural effusion is abnormal accumulation of fluid in the chest or lungs. Ascites and pleural effusions can be due to multiple causes including: liver disease, kidney disease, heart disease, or certain types cancer.
- When the build up of fluid in the abdomen or chest is infrequent or small in volume patients can undergo image guided drainage using ultrasound with a small temporarily placed needle/catheter.
- When patients have a history of frequent large volume drainage procedures, more permanent drainage catheters may be placed which partially tunnel under the patients skin. These tunneled catheters allow the patient to drain the fluid at home without needing to come into the hospital on a regular basis.
- Placement of a tunneled chest or abdominal catheter is performed on an outpatient basis under the guidance of both ultrasound and x-ray. Tunneled drainage catheters may remain in place for weeks to months at a time when cared for appropriately.
- Due to a small however significant risk of infection, tunneled drainage catheters are only appropriate for certain eligible patients. Tunneled drainage catheters are not permanent and if no longer needed can be removed by a simple outpatient procedure. Tunneled drainage catheters that may become infected do need to be evaluated by a doctor and if necessary can also be removed by a simple outpatient procedure.
Joint pain including pain in the back, hips, knees, wrist, shoulders, hands, and ankles can be a result of many medical conditions. Joint injections with anti-inflammatory medications such as steroids and long acting anesthetics can provide some patients with an alternative or bridge to surgery. Joint injections may also represent the sole treatment for acute joint pain in those not eligible for or not interested in more invasive treatments. Utilizing either ultrasound, xray, or CT guidance a small needle can be directed towards a targeted joint space/joint and appropriate medication administered for treatment of both chronic and acute joint pain.
The organs and tissues of the neck, chest, abdomen, arms, and legs can develop both cancerous and non-cancerous growths (knowns as masses/nodules/lesions). In order for your doctor to properly treat these growths, if needed, they need to know the specific type of growth present. Minimally invasive tissue sampling can be performed using ultrasound, x-ray, or CT guidance to give you and your doctor the answer needed to best direct your treatment and management. Biopsies are typically performed on an outpatient basis under moderate sedation. Biopsy samples are sent to the pathology laboratory and the results are sent to your doctor who will then decide the best way to treat you as needed