Interventional Radiology

Interventional Radiology is 21st Century Medicine

Interventional radiology is a rapidly growing area of medicine. Interventional radiologists are physicians who specialize in minimally invasive, targeted treatments performed using imaging guidance. Interventional radiology procedures are an advance in medicine that often replace open surgical procedures. They are generally easier for the patient because they involve no large incisions, less risk, less pain and shorter recovery times.

What is interventional radiology?

Interventional radiologists (IRs) use their expertise in reading X-rays, ultrasound and other medical images to guide small instruments such as catheters (tubes that measure just a few millimeters in diameter) through the blood vessels or other pathways to treat disease percutaneously (through the skin). These procedures are typically much less invasive and much less costly than traditional surgery.

Who are interventional radiologists?

Interventional radiologists are medical doctors who have specialized in doing medical procedures that involve radiology. Radiologists use imaging equipment such as X-rays, magnetic resonance (MR) imaging, ultrasound and computed tomography (CT) to diagnose disease. IRs are board certified radiologists that are fellowship trained in percutaneous interventions using guided imaging. Their specialized training is certified by the America Board of Medical Specialties.

How did interventional radiology develop?

The improved ability of radiologists to see inside the body gave rise to interventional radiology -- minimally invasive targeted treatments performed using imaging for guidance -- in the mid-1970's. Interventional radiologists invented angioplasty and the first catheter-delivered stent, what was first used in the legs, to save patients with vascular disease from amputation or other surgery. These advances pioneered modern medicine and gave rise to the state-of-the-art treatments that are common place today. Interventional radiology is a medical specialty recognized by the American Board of Medical Specialties and the American Medical Association.

Today there are more than 5,000 interventional radiologists in the United States. The Society of Interventional Radiology (SIR), the professional association of interventional radiologists based in Fairfax, VA, has seen its membership steadily increase to more than 4,000 worldwide in 2004.

What are the advantages of interventional radiology?

  • Most procedures can be performed on an outpatient basis or require only a short hospital stay.
  • General anesthesia usually is not required.
  • Risk, pain and recovery time are often significantly reduced.
  • The procedures are sometimes less expensive than surgery or other alternatives.

Where is interventional radiology headed in the future?

As technology advances and high-quality imaging equipment becomes more widely available, interventional radiology is able to offer patients and referral physicians a host of new treatment options.

Common Interventional Procedures

Angiography

An X-ray exam of the arteries and veins to diagnose blockages and other blood vessel problems; uses a catheter to enter the blood vessel and a contrast agent (X-ray dye) to make the artery or vein visible on the X-ray.

Balloon angioplasty

Opens blocked or narrowed blood vessels by inserting a very small balloon into the vessel and inflating it. Used by IRs to unblock clogged arteries in the legs or arms (called peripheral vascular disease or PVD), kidneys, brain or elsewhere in the body.

Biliary drainage and stenting

Uses a stent (small mesh tube) to open up blocked ducts and allow bile to drain from the liver.

Central venous access

Insertion of a tube beneath the skin and into the blood vessels so that patients can receive medication or nutrients directly into the blood stream or so blood can be drawn.

Chemoembolization

Delivery of cancer-fighting agents directly to the site of a cancer tumor; currently being used mostly to treat cancers of the endocrine system, including melanoma and liver cancers.

Embolization

Delivery of clotting agents (coils, plastic particles, gelfoam, etc.) directly to an area that is bleeding or to block blood flow to a problem area, such as an aneurysm or a fibroid tumor in the uterus.

EVLT® (Endovenous laser therapy)

EVLT® (Endovenous laser therapy) is a minimally invasive image-guided technique in which a catheter bearing a laser fiber is inserted under ultrasound guidance into the long saphenous vein through a small puncture at the level of the knee. The catheter is then advanced (also under ultrasound guidance) to the level of the groin and the laser activated resulting in obliteration of the saphenous vein.

Fallopian tube catheterization

Uses a catheter to open blocked fallopian tubes without surgery; a treatment for infertility.

Gastrostomy tube

Feeding tube inserted into the stomach for patients who are unable to take sufficient food by mouth.

Hemodialysis access maintenance

Use of angioplasty or thrombolysis to open blocked grafts for hemodialysis, which treats kidney failure.

Needle biopsy

Diagnostic test for breast, lung and other cancers; an alternative to surgical biopsy.

Radiofrequency (RF) ablation

Use of radiofrequency (RF) energy to cook and kill cancerous tumors.

SIRT

SIRT involves the delivery of millions of microscopic radioactive spheres called SIRSpheres, directly to the site of the liver tumor. SIRSpheres are approximately 35 micron in diameter.

Stent

A small flexible tube made of plastic or wire mesh, used to treat a variety of medical conditions (e.g., to hold open clogged blood vessels or other pathways that have been narrowed or blocked by tumors or obstructions).

Stent-graft

Reinforces a ruptured or ballooning section of an artery (an aneurysm) with a fabric-wrapped stent C a small, flexible mesh tube used to "patch" the blood vessel. Also known as an endograft.

Thrombolysis

Dissolves blood clots by injecting clot-busting drugs at the site of the clot.

TIPS (transjugular intrahepatic portosystemic shunt)

A life-saving procedure to improve blood flow and prevent hemorrhage in patients with severe liver dysfunction.

Uterine artery embolization

An embolization procedure of uterine arteries to stop life- threatening postpartum bleeding, potentially preventing hysterectomy. The same procedure is used to treat fibroid tumors and is then called UFE (Uterine Fibroid Embolization).

Uterine fibroid embolization

An embolization procedure of uterine arteries to shrink painful, enlarged, benign tumors in the uterus, also called UAE (Uterine Artery Embolization).

The Nebraska Medical Center Vascular Center

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