Interventional Radiology


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 less risk, less pain, shorter recovery times and no large incisions.

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 and treat disease. IRs are board certified Radiologists that are fellowship trained in percutaneous interventions using guided imaging. Their specialized training is certified by the American Board of Medical Specialties.

How did Interventional Radiology Develop?

The improved ability to see inside the body with radiologic imaging and the development of tools such as balloon catheters, gave rise to Interventional Radiology (IR) in the mid-1970s. Interventional Radiologists pioneered coronary angiography and other minimally invasive procedures that are commonplace in medicine today. In 1992, the American Medical Association officially recognized IR as a medical specialty, and today there are more than 5,000 Interventional Radiologists in the United States.

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.

Preparation

These are a few general guidelines that apply to all Interventional Radiology procedures. Please see our detailed procedure pages for more information on your specific procedure. Procedures for which you will likely want to receive medication that relaxes and counteracts discomfort require that you be without solid food for at least 6 hours. Patients who will have punctures of the groin arteries will require bed rest for about 2-6 hours depending on the size of the access needle. Patients who have punctures to the groin veins will require bed rest 2 to 4 hours after the procedure. Some procedures to the veins are conducted through the neck and arm vessels and recovery there can be shorter. Finally, for some procedures patients are admitted overnight.

The following is a list of important information all patients must know prior to having any procedure with Interventional Radiology:

All patients must have a ride home.

No food or drinks after midnight except for sips of water to take medications.

All blood pressure medications need to be taken the morning of the procedure.

If patient is on insulin, the patient should only take half of their morning dosage.

If there are any questions about medications, patients should bring their meds with them, or a complete list of the medications which include the dosage.

All blood thinners need to be held 5 days prior to the procedure. Some examples include Coumadin, Aspirin, and Plavix.

Angiography An X-ray 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 (called portal hypertension), brain or elsewhere in the body.
Biliary Drainage and Stenting Uses a stent or small 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 and liver cancers.
Embolization Delivery of clotting agents (coils, plastic particles, gel, foam, 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.
Gastrostomy Tube Feeding tube inserted into the stomach for patients who are unable to take sufficient food by mouth.
Hemodialysis Access and Thrombolysis Use of angioplasty or thrombolysis to open blocked grafts or fistulas used for hemodialysis in patients with kidney failure. IRs can also place temporary or permanent (tunneled) hemodialysis catheters.
Laser Treatment of Varicose Veins Laser (or endovenous) ablation of varicose veins is a non-surgical procedure performed by an Interventional Radiologist with special training in image guided, minimally invasive techniques to treat a wide variety of conditions that once required surgery.
Radiofrequency (RF) Ablation Use of radiofrequency (RF) energy to kill cancerous tumors in various parts of the body, most commonly in the liver, lung and bone.
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 (as aneurysm) with a fabric-wrapped stent, a small, flexible mesh tube used to "patch" the blood vessel. Also known as an endograph.
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 GI hemorrhage in patient 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 causing pain or heavy bleeding.  Follow this link for more information from the SIR website.
Varicocele Embolization A treatment for "varicose veins" in the scrotum, which can cause infertility and pain.
Vena Cava Filter A tiny cage-like device that is inserted in a blood vessel to break up clots and prevent them from reaching the heart or lungs.  These devices can be permanent or temporary.
Vertebroplasty Injection of bone cement into the spine to alleviate pain caused by fractured vertebra, a common result of osteoporosis.

Making an Appointment

When you call, we'll ask you for basic information such as your Social Security number. We'll ask you what type of test you need to schedule, and will schedule you for the best possible time. If you need to reschedule your exam, you can call us back and we'll be happy to arrange a better time for you.

When you call to schedule your exam, we'll also give you important information about preparing for the exam. If your doctor has scheduled the exam for you, and you have questions regarding the preparation or the procedure itself, you can call the imaging department where your procedure is being performed (please refer to our 'Locations' page for exact phone numbers).

Your physician will have several tasks to perform:

Complete the necessary paperwork to order the test (similar to writing a prescription for medication)

Fax, mail, or place the order in our computer system

Call us to schedule a test for you or have your physician call us directly

Obtaining Your Images

Exam Image Availability

DRC's state-of-the-art PACS technology offers you immediate access to the images of your radiologic exam. No longer does your physician have to wait to have copies of your films made. Although we can still print your X-ray on film for you with just 24 hours notice, your physician can now review your exam images immediately via the Internet. We offer safe and secure web access for your physician through Specialty Networks. Your privacy and HIPAA compliance is assured.

Images on a CD

If your physician prefers, the digital images from your study can be written to a CD-ROM, giving him/her a permanent record that can be accessed easily and quickly via a computer. CDs hold multiple studies and take up significantly less space than the traditional film in the brown envelope. A 24-hour notice is also requested to create this digital record for you.

Versatile Image Viewing Options

Internet access to your studies for your doctor is available immediately after your pictures are taken. Copies of your images can be obtained on a CD or on film with 24 hours notice.

Both Internet and CD viewing offer your physician the ability to digitally adjust your images in ways not possible with traditional X-ray film. Using the computer, the image can be made lighter or darker or zoomed for better visualization of a particular portion, for example. Your physician can fine-tune the images to accommodate his or her preferences.

Obtaining Copies of Your Images

To receive a CD or film copies of exam images, please follow these steps:

1. Call the location where your examination was performed (please refer to the locations page). Please provide your name and other identifying information along with the study being requested. With 24 hours notice, we can either create a CD-ROM or print a film for you. Our representative at the imaging center will provide you with the times available to pick up the exam.

2. To protect your privacy, please be sure to bring a picture ID when you pick up your CD/films, you will have to sign a Medical Images Release form when receiving your CD/films. If anyone else picks up your CD/films for you, please be sure to give him or her your written authorization to release your information to him or her.

3. If you would like us to send a copy of your study to a physician outside the DRC system, we will need a signed release from you along with the study you would like sent and the receiving doctor's name and address. You can fax or deliver us that release in the form of a signed letter at the fax number listed on the locations page. Please allow us plenty of time to send your films.

Any Costs

Currently the first set of films is provided at no cost to the patient. There is no charge for CD-ROM's and, of course, the Internet is always free.

LOCATIONS

For the convenience of our patients, we offer Interventional Procedures at several DRC locations:

Hutcheson Medical Center
Tennessee Imaging & Vein Center
Tennessee Imaging Downtown