What is interventional radiology?
Interventional radiologists are involved in the treatment of the patient, as well as the diagnosis of disease. They treat an ever-widening range of conditions inside the body by using various tools, such as catheters or wires, along with the use of X-ray and imaging techniques, such as CT, MRI, and Ultrasound. Interventional radiology offers an alternative to the surgical treatment of many conditions and can eliminate the need for hospitalization, in some cases.
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Needle biopsy, also called image-guided biopsy, is usually performed using a moving X-ray technique (fluoroscopy) computed tomography (CT), ultrasound or magnetic resonance (MR) to guide the procedure. In many cases, needle biopsies are performed with the aid of equipment that creates a computer-generated image and allows radiologists to see an area inside the body from various angles. This helps them pinpoint the exact location of the abnormal tissue.
Needle biopsy is typically an outpatient procedure with very infrequent complications; less than 1 percent of patients develop bleeding or infection. In about 90 percent of patients, needle biopsy provides enough tissue for the pathologist to determine the cause of the abnormality.
Advantages of needle biopsy:
- With image guidance, the abnormality can be biopsied while important nearby structures such as blood vessels and vital organs can be seen and avoided.
- The patient is spared the pain, scarring and complications that are associated with open surgery.
- Recovery times are usually shorter, and patients can more quickly resume normal activities.
- Imaging can provide enhanced pictures, which helps determine if there is more than one area of concern.
Vascular Access for Dialysis Patients
Interventional radiologists can create access for dialysis patients who are receiving hemodialysis, a treatment that cleans the blood by removing wastes and excess water from the body. For this procedure, the radiologist creates a synthetic stent-graft, or fistula in the patient's arm, so that blood can flow out of and into the body for dialysis treatments. This procedure is a viable option for chronic dialysis patients with inadequate arm veins or multiple failed fistulas. It also eliminates the need for a chest port.
Peripheral Arterial Disease
Peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD), is a common condition affecting 12 to 20 percent of Americans age 65 and older. PAD develops most commonly as a result of atherosclerosis, or "hardening of the arteries," which occurs when cholesterol and scar tissue build up, forming plaque, which narrows and clogs the arteries. This causes decreased blood flow to the legs, which can result in severe pain when walking, and eventually gangrene and amputation.
Many people simply live with the pain, assuming it's a normal part of aging. Like heart disease, peripheral arterial disease is under-recognized in women. Through early detection, the progression of vascular disease can be halted, preventing strokes, heart attacks and early death.
The most common test for PAD is the ankle-brachial index (ABI), a painless exam in which a special stethoscope is used to compare the blood pressure in the feet and arms. Based on the results and the patient's symptoms and risk factors, a physician can decide if further tests are needed. Other imaging techniques may be used to confirm the diagnosis, including ultrasound, magnetic resonance (MR) and computed tomography (CT).
Patients considering surgical treatment should see an interventional radiologist to learn about all treatment options. As minimally invasive experts, interventional radiologists are often able to treat difficult cases that another vascular specialist might assume requires surgery.
Interventional radiologists can offer treatment with angioplasty and stenting. Using imaging for guidance, the radiologist threads a catheter through the femoral artery in the groin to the blocked artery in the legs. A balloon is inflated to open the blood vessel where it is narrowed or blocked. In some cases, the artery is held open with a tiny metal cylinder, called a stent. This minimally invasive treatment does not require surgery, just a nick in the skin the size of a pencil tip.
Treatment for Cancer Patients
As vascular experts, interventional radiologists are uniquely skilled at using the vascular system to deliver targeted treatments throughout the body. In treating cancer patients, interventional radiologists attack the cancer tumor inside the body without medicating or affecting other parts of the body. Interventional radiology treatment is less invasive and easier on the patient, because it spares the majority of the healthy tissue and can be repeated if needed. Cancer patients who are not considered candidates for surgery may benefit from interventional treatment options.
Treatment for Patients with Uterine Fibroids
Many women suffering from painful symptoms associated with uterine fibroids are unaware that they have a choice when it comes to treatment. The majority of patients assume that their only option is major surgery, which can be dangerous, expensive and painful. And in many cases, women who have surgery can no longer have children. Uterine fibroid embolization, a minimally invasive procedure, is an alternative to surgery that is often less expensive, involves a shorter recovery time and, in many cases, allows women to have children following the procedure.
Treatment for Patients with Osteoporosis, Compression Fractures
Vertebroplasty and kyphoplasty are image-guided, non-surgical treatments used to strengthen a broken vertebra (back bone) that has been weakened by osteoporosis, cancer, or some other cause.
- Vertebroplasty: Using an image-guided needle, an orthopedic cement mixture is injected into the fractured bone.
- Kyphoplasty: A balloon is used to alleviate the fracture by inserting it into the compressed vertebral body, prior to injecting the cement mixture.
These types of treatments can dramatically improve back pain within hours of the procedure and provide long-term pain relief. Such treatments have a low complication rate, as demonstrated in multiple studies. They can also prevent further collapse of the vertebra, thereby preventing the height loss and spine curvature commonly seen as a result of osteoporosis.