Interventional Radiology

Chances are that unless you have been a patient and heard those words you may not be familiar with interventional radiology.

Interventional radiologists are doctors specializing in image-guided minimally invasive treatments throughout the body. They use their expertise in imaging to place and guide various types of catheters, wires, and needles into the body, usually through a small puncture in the skin. Often the procedures are undertaken to avoid another type of therapy that is more invasive and carries a greater risk. The imaging that guides the procedures can be in various forms. Most of the time a type of X-ray or ultrasound is used.

Is interventional radiology new?

Though you may not recognize the name, interventional radiology (commonly referred to as “IR”) has been around since the mid 1970’s when advances in diagnostic imaging related to fluoroscopy, CT imaging and ultrasound made certain micro invasive treatments possible. Interventional radiologists performed the first angioplasty and delivered the first vascular stent used to treat blockages in various types of arteries. As the number and complexity of these procedures grew, the IR subspecialty was formed and is certified by the American Board of Medical Specialties. Interventional radiologists typically complete four years of medical school, a year of internship, four years of residency in diagnostic radiology, and a year of fellowship in interventional radiology.

What are some types of procedures?

Some are catheter based. A catheter may be advanced through a puncture in the skin to a blood vessel near the groin where it is guided using continuous X-rays to the point of therapy. The treatment site can be a long way from the entry point. Neurointerventional radiologists will guide these catheters up into the brain to perform certain therapies. Catheter based vascular procedures might consist of inserting a venous filter or dilating a narrowing in a blood vessel (angioplasty) which might include insertion of a vascular stent to help the blood vessel stay open or removing a blood clot. Sometimes a blood vessel needs to be blocked. Injection of special occluding materials through a catheter into a bleeding artery or tumor may be necessary. Certain cancers can be treated by injecting chemotherapy directly into the tumor. Other cancers are ablated (killed) by inserting a special type of needle directly in the tumor and heating or freezing it. Sometimes an organ in the body becomes obstructed or infected and requires drainage. Special types of drainage catheters can be inserted through the skin into the organ or infection. Venous ports, piccs, and dialysis catheters are some of the venous catheters inserted daily in IR departments of larger hospitals.

What are some of the advantages of these procedures?

Although no treatment is risk free, interventional radiology procedures tend to be much lower risk than that of open surgery. General anesthesia is usually not required. Typically pain, recovery time, and cost are reduced and many of the procedures can be performed on an outpatient basis.

By combining imaging expertise in diagnostic radiology with advanced training in image- guided nonsurgical techniques, interventional radiologists can provide treatments for a wide range of health problems. By working closely with your primary care physician and other specialists, IR can help provide you with some of the safest and most effective medical
care available.

By Mark J. Stallworth, M.D. Triad Radiology Associates