Interventional Radiology
Our Physicians Jeffrey R. Conaway, M.D.Jason Himmel, M.D.Joseph Koury, M.D.Craig B. McClure, M.D.Robert A. Wood Jr., M.D. |
Interventional radiology offers an alternative to the surgical treatment of many conditions and in some cases can reduce or eliminate the need for hospitalization. Interventional radiologists combine their skill in minimally invasive surgical techniques with their extensive training in advanced imaging modalities such as CT scanners, ultrasound and fluoroscopy to treat a wide range of conditions involving almost every organ system. Procedures are typically performed entirely through small needles or catheters rather than surgical incisions. This allows most procedures to be completed using moderate sedation instead of heavy anesthesia, which in turn results in better comfort for the patient, quicker recovery time, shorter hospital visits, and improved overall risk for the patient.
Who is the interventional radiologist?
The interventional radiologist is a medical doctor who has completed at least 5 and sometimes 6 years of advanced training in both diagnostic and interventional radiology after having completed medical school. Interventional radiologists specialize in diagnostic and therapeutic minimally invasive procedures. These techniques use image guidance (i.e. X-ray, CT Scan, Ultrasound) to place small catheters (spaghetti sized tubes), needles, and other devices into targeted areas of the body. Today, there are about 4,000 interventional radiologists in the US, mainly practicing in academic medical centers and in larger community hospitals. Interventional radiologists work closely with other physicians and play an important role on the treatment
| Conditions We Treat (Partial List) |
Procedures We Perform (Partial List) |
| Peripheral Arterial Disease (PAD) Renal Artery Stenosis(RAS) Mesenteric Artery Stenosis Subclavian Artery Stenosis Carotid Artery Stenosis Aortic Stenosis Aortic Aneurysms Peripheral Aneurysms Mesenteric Aneurysms Arteriovenous Malformations Venous Malformations Deep Venous Thrombosis May-Thurner Syndrome Uterine Fibroids (leiomyomas) Thoracic Outlet Syndrome Abcesses Lung Cancer Liver Cancer Kidney Cancer Bone Cancer Biliary Stenosis Osteoporotic Spine Fractures Traumatic Spine Fractures Tumor Related Spine Fractures Dialysis fistula and shunt failures Refractory Ascites Pleural Effusions |
Angiography Angioplasty Stenting Atherectomy Endograft placement Embolization Coiling of Aneurysms Thrombolysis (clot removal) IVC Filter Placement IVC Filter Retrieval Uterine Artery Embolization Tumor Embolization (TACE) Tumor Ablation (RFA, Cryo) Vertebroplasty Kyphoplasty Drainages Biopsies Hemodialysis Catheters Ports PICCs Groshong Catheters Pleur-X catheters Denver Shunts Gastrosomy Tube Placement TIPS |
What procedures do interventional radiologists perform?
Interventional radiologists perform a vast variety of procedures, including the following:
Angiography. An angiogram involves injecting dye into the arteries or veins and taking a series of x-ray movies to watch the flow of dye through the blood vessels. It is very useful for detecting blockages or areas of narrowing which may be causing symptoms, but can also be used to detect aneurysms, injured vessels and tumors.
Angioplasty and Stent Placement. These procedures are performed in conjunction with angiography and are used to treat blockages inside arteries and veins that can occur nearly anywhere in the body. Angioplasty involves the use of a small balloon that is inflated inside the blocked vessel to open it up. Stents are small expandable metallic devices that can be used to hold open blocked vessels that may not respond well to angioplasty alone. Areas often treated in this manner include arteries of the legs (called Peripheral Arterial Disease or PAD), arteries of the kidneys (Renal Artery Stenosis), arteries of the bowels (Mesenteric Artery Stenosis) and arteries to the arms or neck (Subclavian or Carotid Artery Stenosis). Some venous diseases can be treated with angioplasty and stenting as well.
Embolization. The insertion of small wires, glue, or particles through a catheter into a blood vessel to stop flow within that blood vessel. This is commonly performed for patients with bleeding emergencies, but may be performed electively to treat non-emergent conditions such as symptomatic uterine fibroids, aneurysms, hemorrhaging, or excessive bleeding.
IVC Filters (Blood Clot Filters). Patients who have blood clots in their legs or arms may be at risk of developing a life-threatening pulmonary embolism. An IVC Filter is a small filter which is inserted into a large vein in order to trap blood clots which migrate from the legs or arms before they reach the heart and lungs where they can be fatal.
IVC Filter Retrieval. Many IVC filters are only needed for a short period of time, particularly in patients whose filters were placed because of a recent surgery or trauma, and those who are successfully placed on anticoagulation medication while their body dissolves their existing blood clots. Filters which are no longer necessary can usually be retrieved by the interventional radiologist in a short outpatient procedure.
Thrombolysis (Removal of Blood Clots). Clot-busting agents, such as tissue plasminogen activator (TPA), are injected into the body to dissolve blood clots, thereby increasing blood flow to the heart or brain.
Catheters Insertions. A catheter is inserted into large veins for giving chemotherapy drugs, nutritional support, and hemodialysis. A catheter may also be inserted prior to bone-marrow transplantation. Types of catheters include Ports, Groshong catheters, PICC lines, Central Lines and Tunneled Dialysis catheters.
Needle Biopsy. A small needle is inserted into the abnormal area in almost any part of the body, guided by imaging techniques, to obtain a tissue biopsy. This type of biopsy can provide a diagnosis without surgical intervention. An example of this procedure is called the needle breast biopsy.
Abcess Drainage. Patients with abcesses or other deep fluid collections often require drains. Drains are placed by Interventional Radiologists using imaging guidance to ensure that the drains are placed directly into the fluid collection.
Uterine Artery Embolization. Also know as Uterine Fibroid Embolization, or UFE, this procedure involves passing a small catheter into the arteries that provide blood flow to the uterus. These arteries are then blocked with small particles, which causes uterine fibroids (also called leiomyomas) to shrink and can eliminate some or all of the symptoms patients may be experiences from their fibroids.
Tumor Ablation. Tumors in the liver, kidneys, lungs and bones can often be treated with percutaneous ablation that uses heat, cold, or energy delivered directly to the tumor to destroy the tumor tissue. The Interventional Radiologist typically inserts one or more probes directly into the tumor through the skin using imaging guidance. Types of ablation include Radiofrequency Ablation (RFA), Cryoablation, and Microwave ablation.
Chemoembolization. Also known as TACE, this procedure is primarily used for treatment of primary or metastatic tumors in the liver which cannot be surgically removed. The procedure involves passing a small catheter into the liver artery and injection chemotherapy and small particles directly into the vessels which supply oxygen and nutrients to the tumor(s).
Vertebroplasty and Kyphoplasty. These procedures involve injecting bone cement into painful fractures of the spine, which have typically occurred due to osteoporosis or trauma, but may be from bone tumors as well.
TIPS. This procedure involves diverting blood from the liver by creating a shunt, or alternative pathway, for the blood flow from the portal vein directly into the central venous system. This is usually done to treat recurrent esophageal bleeding or chronic ascites in patients with liver disease such as cirrhosis.
Gastrostomy tubes. A gastrostomy tube (feeding tube) is inserted into the stomach if the patient is unable to take food by mouth.
Foreign Body Extraction. The use of a catheter inserted into a blood vessel to retrieve a foreign body in the vessel.
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