27

IR Procedures

Minimally-invasive treatments performed by interventional radiologists
Interventional radiologists can treat many conditions without surgery.
 
Interventional radiology is a radiological subdiscipline providing minimally invasive treatments performed under image guidance. As technology advances and high-quality imaging equipment becomes more widely available, interventional radiology is able to offer patients and referral physicians a growing number of new treatment options. These procedures are typically guided by x-ray fluoroscopy, ultrasound or computed tomography. For details about the ailments treated by interventional radiologists and the corresponding procedures, please select from the list of choices on the left side of your screen or click on the links below.
 
 
Common Interventional Procedures

 

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.
 
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.
 
Uses a stent (small mesh tube) to open up blocked ducts and allow bile to drain from the liver.
 
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.
 
Chemoembolisation
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.
 
Embolisation
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 in the uterus.
 
Uses a catheter to open blocked fallopian tubes without surgery; a treatment for infertility.
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.
 
Hereditary Hemorrhagic Telangiectasia (HHT) also called Morbus Osler is an inborn genetic disorder of small blood vessels that affects about one in 2.500 – 40.000 people in Europe with regional differences and causes arterial blood to flow directly into the veins, creating weakened ballooned vessels that can rupture in various locations.
 
Diagnostic test for breast, lung and other cancers; an alternative to surgical biopsy.
 
Use of radiofrequency (RF) energy to cook and kill cancerous tumors.
 
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 (a small, flexible mesh tube used to "patch" the blood vessel). Also known as an endograft.
 
Dissolves blood clots by injecting clot-busting drugs at the site of the clot.
A life-saving procedure to improve blood flow and prevent hemorrhage in patients with severe liver dysfunction.
 
An embolisation procedure of uterine arteries to stop life- threatening postpartum bleeding, potentially preventing hysterectomy. The same procedure is used to treat fibroid tumours and is then called UFE (uterine fibroid embolisation).
 
 
 
 
An embolisation procedure of uterine arteries to shrink painful, enlarged, benign tumors in the uterus, also called UAE (uterine artery embolisation).
 
Vertebroplasty is an outpatient procedure performed using conscious sedation. An interventional radiologist inserts a needle through a small incision in the back, directing it under fluoroscopy (continuous, moving X-ray imaging) into the fractured vertebra. The physician then injects a medical-grade bone cement into the vertebra. The cement hardens within about 15 minutes and stabilizes the fracture.

 

 
Interventional radiologists can treat many conditions without surgery:

Aneurysms Sections of blood vessels that bulge or balloon out abnormally (aneurysms), often may be treated without surgery by interventional radiologists. The doctor threads a thin tube (catheter) into the blood vessel and inserts a device that blocks off the supply of blood to the aneurysm.
 
 
Arteriovenous Malformations (AVM) are blood vessel abnormalities in the brain or elsewhere. If untreated, AVMs can rupture, causing life-threatening bleeding. Interventional radiologists can often treat these abnormalities without surgery by guiding thin tubes (catheters) to the site and injecting a substance that blocks the supply of blood to the affected blood vessels.
Top
 
Bleeding Internally When a patient is bleeding inside the body due to injured blood vessels after an accident or other trauma, the interventional radiologist pinpoints the area of injury with angiography. The doctor injects a clotting substance, such as a gel, foam, or tiny coils, through a thin tube (catheter) to stop the bleeding.
 
 
 
Blood Clots that form in the deep veins of the lower legs (known as deep vein thrombosis or DVT) can cause chronic swelling and leg pain when walking. There is a risk that the clots will move to the lung (pulmonary embolism) or heart -- a potentially life-threatening complication. Interventional radiologists treat DVT by dissolving the clot with thrombolytic therapy. This treatment opens up blood flow and may prevent permanent damage to the blood vessels, a common side effect of DVT.
 
 
 
Blood Clot Filters Patients with certain chronic illnesses or other conditions that require prolonged periods of inactivity, are at risk of forming blood clots that can travel to the heart or lungs. The interventional radiologist can insert a small filter (called a vena cava filter) into a blood vessel to catch and break up blood clots.
Top
 
Cancer Treatments Some types of cancers, such as those of the endocrine system that have spread to the liver, can be treated by delivering cancer-fighting agents directly to the site of a tumor in a procedure known as chemoembolisation.
 
 
 
High Blood Pressure In some patients with high blood pressure, the condition is caused by a narrowing of the arteries in the kidneys. The problem, called renal hypertension, often can be treated with angioplasty.
 
Infection and Abscess Drainage
Patients with a variety of illnesses may develop an area of persistent infection (abscess) in the body. The infection can be drained by inserting a thin tube (catheter) through a small nick in the skin< and to the site of the infection.
 
 
Urinary Tract Obstruction The ureter -- the tube that carries urine from the kidneys to the bladder -- sometimes becomes blocked by kidney stones or other obstructions. The interventional radiologist inserts a thin tube (catheter) through a small nick in the skin and into the blocked kidney to drain.
Top
 
 
Partially edited with the permission of the Society of Interventional Radiology - www.sirweb.org