What is Interventional Radiology?
Interventional Radiology is a sub-specialty of radiology where doctors use medical imaging to guide minimally invasive procedures. Interventional radiologists use advanced imaging techniques such as fluoroscopy, ultrasound, and computed tomography (CT) scanning to guide needles, catheters, and wires through tiny incisions in the body to diagnose and treat a large variety of diseases and conditions. At AMIR, our interventional radiologists offer cutting edge solutions… without the cutting! Because interventional radiology procedures are so minimally invasive, they require less anesthesia than surgery and the recovery is faster. Most IR procedures are done outpatient and you can go home the same day.
Who are Interventional Radiologists (IRs)?
Interventional Radiologists (IRs) are medical doctors that have gone through many years of training to become specialists in minimally invasive therapy. After completing medical school and internship in medicine or surgery, they study medical imaging in radiology residency before subspecializing in interventional radiology fellowship. They are experts at interpreting your medical images while using that information and their clinical expertise to offer you the best options for your treatment while working closely with your other physicians. Interventional radiologists use their expertise in interpreting medical imaging during your minimally invasive image guided procedure to ensure the best outcome.
What Procedures Can an IR Do?
There is a wide variety of minimally invasive image guided procedures (MIIPs) which are used to diagnose and treat various diseases and conditions.
Biopsy
Your IR can use imaging, usually CT or ultrasound to get a needle into an organ or tumor in your body. Once the needle is there, samples can be taken for biopsy.
Examples:
- Lung mass biopsy
- Kidney biopsy
- Liver and liver tumor biopsy
- Thyroid biopsy
Drainage
Examples:
- Abscess drain
- Cholecystostomy
- Biliary drain
- Nephrostomy
Ablation
In ablation, imaging is used to guide a special needle called a probe to treat tumors or painful nerves. Probes can burn the target with radiofrequency (RF) or microwave energy or freeze the target with ice in cryoablation. In some procedures, needles can be used to inject alcohol to perform chemical ablation.
Examples:
- Lung tumor ablation
- Liver tumor ablation
- Kidney tumor cryoablation
- Facet Neurolysis
- Celiac Plexus Neurolysis
Angiography
Angiography means imaging of blood vessels. An IR can access your blood vessels using imaging and inject dye or carbon dioxide to take special x-ray pictures of what the vessels look like. Angiography can be performed of arteries, veins, and portal veins. An IR can also image and treat other types of vessels in your body including lymphatics, bile ducts, and the urinary collecting system.
Angioplasty & Stenting
If an angiogram finds an abnormality with a narrow or blocked vessel, your IR can perform a minimally invasive procedure to open the vessel with a balloon (angioplasty) or a permanent metallic stent. In some cases, your IR may need to scrape away plaque from inside a diseased vessel (atherectomy) or break up and remove clot (thrombolysis and thrombectomy).
Examples:
- Venous Stenting for blockages due to tumors and May-Thurner’s syndrome.
- Arterial angioplasty and stenting for peripheral arterial disease
Embolization
Sometimes, your IR doctor may need to shut down blood flow instead of opening it up. This can help shrink tumors, stop bleeding, or block abnormal veins. Shutting down blood vessels is called embolization. Embolization can be used to treat a wide variety of disorders.
Examples:
- Liver tumor embolization with radioactive beads (Y90 Radioembolization).
- Uterine fibroid embolization to shrink and treat painful or bleeding uterine fibroids.
- Prostate embolization to shrink prostates causing lower urinary tract symptoms.
- Embolization of aneurysms to prevent bleeding.
- Varicocele embolization to treat scrotal swelling, pain, and infertility
- Varicocele embolization to treat scrotal swelling, pain, and infertility
- Gonadal vein embolization to treat chronic pelvic pain
Varicose Vein Treatment
Your IR can use ultrasound guidance to find and close abnormal veins in your legs with glue, radiofrequency ablation, or sclerotherapy.
Spine Fracture Treatment
An IR can use X-ray fluoroscopy guidance to place a needle into a fractured bone in your spine and place cement in to stop pain.
Central Venous Access
IRs can place catheters to allow access into the deep veins such as larger catheters for hemodialysis, smaller catheters for antibiotics, or ports to administer chemotherapy.
Other Procedures
A wide variety of other image guided procedures can be performed by your IR doctor.
- Gastrostomy feeding tube placement.
- Biliary stent placement
- Ureteral stent placement
- Dialysis access interventions
- Portal hypertension interventions
Preparation For Interventional Radiology
In preparation for the interventional radiology procedure:
- If your procedure requires sedation or anesthesia, you should not eat or drink anything after midnight the night before the procedure. This does not apply to medications. Please continue to take your medications with small sips of water.
- Do not stop taking your medications unless instructed by your doctor.
- Inform your doctor if you are pregnant.
- Try to remove jewelry and metallic items during the procedure.
- You may be instructed to change into a patient gown.
Preparation For Interventional Radiology
In preparation for the interventional radiology procedure:
- If your procedure requires sedation or anesthesia, you should not eat or drink anything after midnight the night before the procedure. This does not apply to medications. Please continue to take your medications with small sips of water.
- Do not stop taking your medications unless instructed by your doctor.
- Inform your doctor if you are pregnant.
- Try to remove jewelry and metallic items during the procedure.
- You may be instructed to change into a patient gown.
Post Procedural Care For Interventional Radiology
After the procedure, you may require some time for recovery if you are given sedation. You will be evaluated by your doctor in a recovery room before discharge. You will also be given post-care instruction based on the type of procedure. The contrast dye will be gradually excreted through the urine. You should watch for signs of infection at the incision site such as increasing pain, redness or swelling and inform your doctor immediately if present.
Benefits Of Interventional Radiology
Benefits of interventional radiology include:
- Faster recovery
- Shorter hospital stay
- Less pain
- Lower costs
- Lower risks
Risks And Complications Of Interventional Radiology
Interventional radiology procedures have minimal risks that may include:
- Infection
- Bleeding
- Pain
- Bruising
