Interventional Services

What is Interventional Radiology?

Interventional radiology (also known as IR) is the minimally invasive, image-guided treatment of medical conditions that once required open surgery.

By harnessing the power of advanced imaging (ultrasound, X-rays, CAT scans, MRI scans and other innovative methods), interventional radiologists can see inside your body and treat complex conditions—even cardiovascular disease and cancer—less invasively and with unprecedented precision.

The result? IR can reduce the length of hospital stays, minimize potential complications and save lives.

What is Interventional Radiology?

Interventional radiology (also known as IR) is the minimally invasive, image-guided treatment of medical conditions that once required open surgery.

The result? IR can reduce the length of hospital stays, minimize potential complications and save lives.

Conditions and Treatments

Learn more about how Interventional Radiology can help diagnose and treat various medical conditions.

Angiography

Angiography is an exam of the arteries and veins to diagnose blockages and other blood vessel problems. The physician inserts a catheter into the artery through a tiny incision in the skin and injects X-ray dye to make the blood vessels visible and identify the exact location of the problem. If your doctor finds a narrowing or blockage, he or she can open it with angioplasty or thrombolysis.

During angioplasty, your physician inserts a very small balloon attached to a catheter into a blood vessel through a tiny incision. He or she threads the catheter under X-ray guidance to the site of the narrowed artery where it inflates, opening the artery. Sometimes a small metal stent is inserted to hold the blood vessel open.

Benign Prostatic Hyperplasia (Enlarged Prostate)

Prostate Artery Embolization

Prostate artery embolization (PAE) is a new treatment option for men with benign prostatic hyperplasia (BPH), also known as an enlarged prostate gland. This procedure can greatly reduce BPH symptoms.

Most often patients are discharged from the hospital three hours after the procedure, but sometimes it may be necessary to stay overnight.

Deep Vein Thrombosis/Pulmonary Embolism

Deep vein thrombosis is a blood clot or thrombus in a deep vein. It is most common in the leg. But one may develop in the arm or other part of the body. Part of the clot, called an embolus, can break off and travel to the lungs. This is a pulmonary embolus (PE). This can cut off the flow of blood. PE is an emergency and may cause death.

Traditionally, treatment has been with anticoagulation, medications that thin the blood and prevent the clot from growing.

In certain circumstances, patients may benefit from catheter directed thrombolysis, which involves directly injecting medication into the clot to dissolve it, and/or mechanical thrombectomy, which involves using a device to break up and suck out the clot.

Scarring from DVT, such as in conditions like May Thurner, may require stenting of the veins to keep blood flowing.

Dialysis Access Management

Patients undergoing dialysis for kidney failure may develop narrowing and blockage of their dialysis access grafts and fistulas. We can open up failing or failed grafts/fistulas using a combination of clot-dissolving drugs, clot-busting tools, angioplasty and stents. These techniques may allow for a longer use of a graft, avoiding the need for surgical revision. We can also place catheters directly into the veins of renal failure patients for dialysis.

Feeding Tube Placement

Gastrostomy Tube

Placed when a patient needs to receive nutrition directly through a tube inserted into the stomach or to drain the stomach when its other outlets are blocked. We insert the tube into the stomach under X-ray guidance. This procedure is a good alternative to endoscopies.

Jejunostomy Tube

A jejunostomy is similar to a gastrostomy except instead of inserting a catheter into the stomach, the physician inserts it into the small bowel in order to provide nutrition.

Hypertension

About 10 percent of patients with high blood pressure have a narrowing of the artery to one or both kidneys, which causes their hypertension. This condition is known as renovascular hypertension.

This condition can be suspected when a patient’s blood pressure cannot be controlled with multiple medications.

Diagnosis can be obtained with a renal vascular duplex ultrasound.

Interventional radiologists are able to perform an angioplasty and stent the renal artery when there is a clinically significant narrowing.

Infertility

Fallopian Tube Recanalization

Fallopian tube recanalization (FTR) is an innovative, non-surgical procedure to diagnose and treat blockages in the fallopian tubes. FTR requires no anesthesia or incisions and is highly successful in resolving a wide range of fertility problems.

In FTR, the interventional radiologist places a catheter in the uterus and injects X-ray dye to view the uterine cavity. If the physician detects a blockage, he or she will thread another catheter into the fallopian tube to open it. FTR typically takes less than an hour and most patients return to their normal activities the next day.

Varicocele Embolization

Varicoceles, tangled blood vessels or varicose veins in the scrotum, are a major cause of male infertility. We treat varicoceles non-surgically with a procedure called varicocele embolization.

Your physician threads a catheter through a small skin incision and into the affected vein. They inject either a drug, a small balloon, or tiny metal coils, through the catheter to block off the varicocele. The swollen veins shrink, often resolving the infertility problem. In addition, varicocele embolization can be helpful when surgery has been unsuccessful.

IVC Filter Placement/Retrieval

IVC filters are placed when a patient develops a clot in their legs and cannot be put on blood thinning medication due to a particular contraindication. They can also be placed when a patient who is on blood thinning medication may need to come off his/her medication for an expected surgery.

Most IVC filters are meant to be placed temporarily. When they are no longer needed, they should be removed because they can cause problems when they are left in the IVC for prolonged periods.

Kidney Cancer (Renal Cell Carcinoma)

Cryoablation

Cryotherapy uses imaging guidance, a needle-like applicator called a cryoprobe, and liquid nitrogen or argon gas to create intense cold to freeze and destroy diseased tissue, including cancer cells. It may be used to treat a variety of skin conditions as well as tumors within the liver, kidneys, bones, lungs and breasts.

This works best for cancers that are less than 3 cm.

Microwave Ablation

Microwave ablation (MWA) is a treatment that uses CT guidance to place a needle through the skin into a tumor within the kidney. Microwaves are created from the needle to create a small region of heat. The heat destroys the lung cancer cells. This may be used to treat kidney tumors or provide palliative care. It is an effective treatment options for patients who might have difficulty with surgery and for those for who desire a minimally invasive approach to their kidney cancer.

This works best for cancers that are less than 3 cm.

Liver Disease

TIPS (Transjugular Intrahepatic Portosystemic Shunt)

TIPS is a procedure interventional radiologists use to non-surgically treat portal hypertension. Portal hypertension occurs when liver scarring or damage (cirrhosis) blocks the normal flow of blood through the liver, resulting in build up of fluid in the abdomen (ascites) and/or bleeding from dilated veins in the esophagus and stomach.

The physician inserts a catheter in the skin near the neck and guides it to the blocked blood vessels in the liver. The physician constructs a tunnel in the liver so the blood may flow normally using X-ray guidance. An inserted metal stent keeps the tunnel open. TIPS usually provides prompt relief of symptoms.

Biliary Duct Drainage and Stenting

A byproduct for some patients with liver cancer or trauma to the liver are blocked bile ducts that cannot drain.

Interventional radiologists can insert a catheter through a tiny incision directly into the bile ducts for draining. Sometimes a stent is inserted into the liver to keep the blocked area flowing.

Liver Cancer

Radioembolization

Radioembolization is a minimally invasive procedure that treats liver cancer. Tiny glass or resin beads filled with the radioactive isotope yttrium Y-90 are injected into the blood vessels that feed a tumor. This delivers a high dose of radiation to the tumor while sparing normal tissue. It can help extend the lives of patients with inoperable tumors and improve their quality of life.

Radioembolization is used to treat tumors that were initially formed in the liver or have spread to the liver from another part of the body (colon, pancreatic, neuroendocrine).

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Chemoembolization

Transarterial chemoembolization or TACE places chemotherapy and synthetic materials called embolic agents into a blood vessel feeding a cancerous tumor to cut off the tumor’s blood supply and trap the chemotherapy within the tumor. It is most often used to treat liver cancer but may also be used in patients whose cancer has spread to other areas of the body. Chemoembolization may be used as a standalone treatment or in combination with surgery, ablation, chemotherapy or radiation therapy.

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Ablation (RFA and Microwave)

Radiofrequency ablation (RFA) and microwave ablation (MWA) are treatments that use image guidance to place a needle through the skin into a liver tumor.

In RFA, high-frequency electrical currents are passed through an electrode in the needle, creating a small region of heat.

In MWA, microwaves are created from the needle to create a small region of heat.

The heat destroys the liver cancer cells. RFA and MWA are effective treatment options for patients who might have difficulty with surgery or those whose tumors are less than one and a half inches in diameter. The success rate for completely eliminating small liver tumors is greater than 85 percent.

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Lung Cancer

Microwave Ablation

Microwave ablation (MWA) is a treatments that use CT guidance to place a needle through the skin into a tumor within the chest. Microwaves are created from the needle to create a small region of heat. The heat destroys the lung cancer cells. This may be used to treat lung tumors or provide palliative care. It is an effective treatment options for patients who might have difficulty with surgery and for those for whom surgery is not an option due to the spread of a tumor to the lungs from the primary tumor or cancers outside the chest.

Cryoablation

Pelvic Congestion Syndrome

Varicose veins in the pelvis can produce constant, dull pain and pressure in the abdomen and back. We refer to this as pelvic congestion syndrome. Traditionally difficult to diagnose and treat, we can now do so using ovarian vein embolization— a new and highly effective minimally invasive procedure that shrinks the veins by blocking blood flow.

The interventional radiologist inserts a thin catheter through the neck, threading it into the swollen pelvic veins using X-ray guidance. They insert tiny coils to block the veins, cutting blood flow to the affected area and relieving painful pressure. The procedure takes about an hour and patients return to normal activities within two to three days.

Peripheral Vascular Disease

Peripheral vascular disease (PVD) is a condition in which the arteries that carry blood to the arms or legs become narrowed or clogged with plaque, interfering with normal blood flow. Interventional radiologists can evaluate and treat the condition using angiography, ball angioplasty and stent placement, and thrombolytic therapy.

Uterine Fibroid Embolization (UFE)

Uterine fibroids are non-cancerous tumors that develop within the uterus, most commonly in women of childbearing age. Their size, location and type can contribute to pain and heavy menstrual bleeding.

UFE is a highly-effective alternative to hysterectomy that eliminates fibroids without removing the uterus. We use ultrasound, magnetic resonance imaging (MRI) and computed tomography (CT) to confirm the presence of uterine fibroids.

During UFE, the interventional radiologist inserts a catheter into an artery through a tiny incision at the top of the thigh. Using X-ray imaging for guidance, your doctor directs the catheter into the uterine artery and injects tiny particles into the blood vessels leading to the fibroids. These particles block blood supply, causing the fibroids to shrink. The particles remain at the fibroid sites and can’t travel to other parts of the body.

The procedure usually takes less than an hour and patients typically go home the same day.

Vertebral Fractures

Vertebroplasty and kyphoplasty are procedures used to treat painful vertebral compression fractures in the spinal column, which are a common result of osteoporosis.

An interventional radiologist will use imaging guidance to inject a cement mixture into the fractured bone (vertebroplasty) or insert a balloon into the fractured bone to create a space and then fill it with cement (kyphoplasty). Following vertebroplasty, about 75 percent of patients regain lost mobility and become more active.

A similar procedure can be performed for pelvic fractures (sacral insufficiency fractures).

Cancer that spreads to the bones can also weaken the bones and result in a fracture. Microwave ablation of the tumor can be performed followed by kyphoplasty to stabilize the fracture and relieve the pain.

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What is Interventional Radiology?

What is Interventional Radiology?

Conditions and Treatments

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