Interventional
Studies
Interventional radiologists are highly trained medical professionals who play a critical role in modern healthcare. Their expertise lies in utilizing advanced imaging techniques – treating a wide range of medical conditions – through minimally invasive procedures.
Interventional radiologists at Wake Radiology are instrumental in enhancing patient care, often avoiding the need for more invasive surgeries and reducing recovery times. With their ability to precisely target and treat specific areas within the body, interventional radiologists are essential partners in achieving optimal patient outcomes across various medical specialties
How an Interventional study is performed
Interventional radiology procedures are conducted with precision and expertise using advanced imaging guidance. Typically, the process begins with the patient lying on an examination table, and a local anesthetic may be administered to numb the area of interest. Interventional radiologists then use techniques like fluoroscopy, ultrasound, CT scans, or MRI to visualize the internal structures in real-time. Through small incisions or catheters, they navigate specialized instruments to the target area. These minimally invasive techniques enable them to perform a wide range of procedures, such as angioplasty, embolization, stent placement, or biopsy, with minimal discomfort and risk to the patient. The real-time imaging feedback ensures accuracy and safety throughout the procedure. Once completed, patients typically experience shorter recovery times and reduced post-operative discomfort compared to traditional surgical methods, making interventional radiology a vital component of modern medical care.
Interventional Resources
Common Interventional Studies
Abscess / fluid
Fluid can build up in many parts of the body, including the abdomen, pelvis, or chest. This may be due to any number of causes, including inflammation, infection, or cancer. Frequently, medications are unable to treat the buildup of fluid, and drainage of the fluid is needed. When the fluid is infected and walled-off, it is called an abscess. Wake Radiology’s IR doctors can use minimally-invasive techniques to drain the fluid. These procedures may utilize small tubes or catheters to access the fluid, under ultrasound, CT-scan, and/or x-ray guidance.
Biliary obstruction
Bile is fluid produced in the liver that helps in the digestion of food. Bile can be stored in the gallbladder and travels through the bile ducts, eventually entering the bowel where it is added to the consumed food. Gallstones, tumors, or scarring can block the bile ducts, causing a backup of fluid. This can result in jaundiced coloration, itching, or dark urine. Interventional Radiologists can perform biliary intervention procedures in order to improve the flow of bile past an obstruction.
Compression Fracture
Patients who suffer from osteoporosis are at risk for compression fractures involving spinal vertebrae. Osteoporosis weakens the bone, and, sometimes, very minor forces can cause a part of the vertebrae to collapse. Through modern minimally invasive techniques compression fractures can be treated by the Interventional Radiologists at Wake Radiology.
Two primary minimally invasive techniques for treating spinal compression fractures are:
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Vertebroplasty: In this procedure, a special bone cement (usually polymethylmethacrylate) is injected directly into the fractured vertebra through a small incision. The cement hardens quickly, stabilizing the vertebra and providing immediate pain relief. Vertebroplasty is often performed on an outpatient basis, and patients can experience significant pain reduction almost immediately.
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Kyphoplasty: Similar to vertebroplasty, kyphoplasty involves the injection of bone cement into the fractured vertebra. However, it includes an additional step of inflating a balloon-like device (a kyphoplasty balloon) within the vertebra before cement injection. This balloon helps to restore some of the vertebra’s height and correct spinal deformity caused by the fracture. Once the vertebra is expanded to the desired height, the cement is injected. Kyphoplasty can provide not only pain relief but also potential restoration of spinal alignment.
Both vertebroplasty and kyphoplasty are performed under local anesthesia and fluoroscopic guidance to ensure precision and safety. These minimally invasive procedures offer several advantages over traditional surgery, including shorter recovery times, reduced risk of complications, and the ability for patients to return to their daily activities more quickly. However, the suitability of these treatments depends on individual patient factors and the specific characteristics of the spinal compression fracture.
To arrange a consultation and learn more about spinal compression fracture treatment options at Wake Radiology, call the interventional scheduling team at 919-788-1916.
DVT / PE (Deep Vein Thrombosis / Pulmonary Embolus)
Hemorrhage
Hemorrhage, or bleeding, can occur at numerous sites in the body, including the gastrointestinal tract, uterus, or solid organs from trauma. Bleeding can occur in the lungs after years of chronic Inflammation. Not uncommonly, bleeding can be brisk, and patients may be unstable. Major surgical exploration is risky when a patient is unstable. Many patients with hemorrhage can benefit from an embolization procedure, which works to stop the bleeding by targeting the blood vessels from within. Interventional Radiology physicians at Wake Radiology have many tools at their disposal to treat episodes of hemorrhage, using minimally-invasive techniques under image-guidance.
Kidney cancer
Cancer can arise anywhere in the body, including the kidneys. Frequently, small solid tumors in the kidneys are asymptomatic and detected during abdominal imaging for other reasons. A variety of treatment options are available for patients with kidney tumors, including surgical and non-surgical treatments. Surgical treatments performed by Urologists include operations during which the kidney is removed or a part of the kidney is removed. Interventional Radiologists at Wake Radiology are able to treat smaller kidney tumors using thermal ablation techniques such as cryoablation or microwave ablation. Interventional Radiologists can also perform a kidney embolization prior to surgery in order to decrease blood loss during the operation.
Kidney failure
Patients whose kidneys are failing may require a biopsy of one of the kidneys in order to determine which treatments, if any, are available to prolong kidney function. Patients whose kidneys have already failed may require dialysis, a method of filtering substances from the blood. In order to perform dialysis, access to the bloodstream is needed (hemodialysis). This access may be in the form of a graft or fistula under the skin of one of the arms or a catheter (large IV) entering one of the large central veins of the chest, typically through a vein of the neck or upper chest. Wake Radiology Interventional Physicians are experts in image-guided hemodialysis catheter placement, catheter manipulations and exchanges, catheter removals, and difficult venous access cases.
Kidney stones
A number of different conditions can result in the formation of mineral deposits such as calcium in the collecting system of the kidneys where urine is formed. Patients who develop stones can suffer symptoms such as back pain, nausea, and vomiting. When the stones block the flow of urine, urine can back up, causing abnormal pressure on the kidney and risking a decrease in kidney function. Interventional radiologists can help in the treatment of kidney stones either by placement of a nephrostomy catheter for relief of urinary obstruction or a nephroureteral catheter to be used by the urologist for access during a stone removal surgery.
Liver Cancer
Cancer can arise in the liver (primary tumors) or can spread to the liver from other organs (metastatic tumors). Sometimes tumors in the liver need to be biopsied in order to determine the tissue type and most appropriate therapy. A number of different treatment options are available for patients with liver tumors, depending on a number of factors. Multiple specialists such as Medical Oncologists, Surgeons, Radiation Oncologists, and Interventional Radiologists work together and participate in the care of patients with liver cancer. Interventional Radiologists at Wake Radiology use a number of different treatment techniques for these patients, including Y-90 radioembolization, chemoembolization, or microwave ablation.
Gastrointestinal / Biliary Interventions
Consultation
At Wake Radiology, our Interventional Radiologists will meet with patients to discuss their symptoms and health history, as well as review any pertinent imaging prior to determining the best treatment options. Prior to any minimally-invasive procedure, the physician will discuss expected outcomes, risks, and alternative therapies with the patient and their family. The referring doctor will be updated regarding the treatment plan.
Abscess drain
A drainage catheter may be placed into an abscess or walled-off collection of infected fluid in order to allow the fluid to be removed. This can be accomplished with imaging guidance, including ultrasound, CT scan, or x-ray fluoroscopy. This is usually done with local anesthetic and sometimes IV medication for conscious sedation. The catheter will usually remain in place for a period of time to ensure the collection is completely treated.
Biliary drain/intervention
Bile is fluid that is produced in the liver and secreted into bowel to aid in digestion. In order to improve the flow of bile through a bile duct that is partially blocked, Interventional Radiologists can use imaging guidance to help place a drainage catheter. This allows bile to bypass the obstruction and flow into the bowel (internal drainage) and/or drain to the outside of the body into a small bag (external drainage). Ultrasound and x-ray guidance may be used in the placement of these drainage catheters. For some patients, internal stent grafts with metallic lattice may be appropriate in order to improve bile flow.
Cholecystostomy (Gallbladder Drainage)
The gallbladder functions to store bile that is produced by the liver. When the gallbladder is unable to contract well in order to squeeze the bile out into the bowel or when the gallbladder is blocked by gallstones, patients may have pain in the right upper abdomen. Fluid can build up within the gallbladder, making it swollen and sometimes infected. When removing the gallbladder by surgery is too risky or in order to allow the infection to resolve, the gallbladder can be drained with a small tube to the outside of the patient. Interventional Radiologists use imaging guidance in order to place this tube (about the size of a thin straw) directly into the gallbladder. Ultrasound and fluoroscopic x-ray guidance are typically used, and the procedure is performed with local anesthetic and IV medication for conscious sedation. The tube can be left in place until the gallbladder can be safely removed.
Gastrostomy (G) tube
A gastrostomy tube is a way to feed patients directly into the stomach when they are unable to receive adequate nutrition orally. Using minimally-invasive image-guided techniques, Interventional Radiologists are able to create a path between the stomach and skin where a tube can be inserted. Patients can then be given liquid nutrition through this catheter in order to meet their nutritional needs.
Gastrojejunostomy (GJ) tube
Sometimes, patients require a feeding tube that enters into their small bowel for their nutritional needs. They may be unable to tolerate a tube in their stomach because of backup of feedings into their esophagus. Therefore, a tube extending into the small bowel can be placed, usually from a path that enters through the skin, into the stomach, and down into the small bowel. Interventional radiologists use imaging guidance including fluoroscopic x-ray imaging and may convert a gastrostomy tube into a gastrojejunostomy tube for feedings.
GI Hemorrhage Embolization
The gastrointestinal (GI) tract has a rich network of blood vessels throughout it in order to absorb nutrients after meals. Hemorrhage from some of these blood vessels into the bowel can occur with ulcers, tumors, diverticulosis, or vascular malformations. In order to quickly stop the bleeding and avoid the need for a major surgery (bowel removal), Interventional Radiologists can perform minimally-invasive embolization procedures to stop the bleeding. Different materials such as medical-grade metallic coils can be placed into the bleeding blood vessels through a long thin micro-catheter (about the size of a strand of spaghetti). These procedures are performed in the Interventional Radiology using fluoroscopic x-ray guidance while patients are partially conscious but sedated with IV medication.
Paracentesis
A paracentesis is a procedure performed to remove fluid from the abdominal cavity. Abdominal fluid may build-up due to a number of factors, including liver disease and cancer. In order to drain the fluid, imaging guidance is used. After sterile prep of the skin, skin is anesthetized or numbed. Using ultrasound guidance, a small catheter like an IV is inserted into the fluid, and the appropriate amount of fluid is drained. Sometimes the fluid is sent to the lab for testing. A bandage is placed over the skin when finished.
Percutaneous Transhepatic Cholangiogram (PTC)
Typically performed in conjunction with a biliary drainage, percutaneous transhepatic cholangiogram (PTC) imaging is performed in order to map out the anatomy of the bile ducts in the liver. Ultrasound and/or fluoroscopic x-ray guidance can be used. Patients are given local anesthetic and IV conscious sedation medication. Then, using imaging guidance, a tiny needle is inserted into one of the bile ducts of the liver. A contrast agent (x-ray dye) is injected in order to make the bile ducts visible. Images are then reviewed.
Transjugular Liver Biopsy (TJLB)
Samples of tissue from the liver (biopsy) are frequently needed for diagnostic testing. However, it is sometimes unsafe to obtain these directly through the skin into the liver, because of high bleeding risk. In these cases, a biopsy of liver tissue can be obtained by accessing the liver through the internal network of blood vessels by one of Wake Radiology’s IR doctors. Local anesthetic and IV conscious sedation are given during the procedure. Imaging guidance is then used to access a vein in the neck. Through this vein, a small sheath or tube like a large IV is placed, and then, using fluoroscopic x-ray guidance, a biopsy device is advanced into the liver through the hepatic veins. Biopsy specimens are taken and given to the pathology lab for analysis.
Genitourinary Interventions
Consultation
At Wake Radiology, our Interventional Radiologists engage in thorough consultations with patients to assess their symptoms, evaluate their medical history, and examine relevant imaging studies before devising the most suitable treatment strategies. Before proceeding with any minimally-invasive procedure, the physician will hold comprehensive discussions with the patient and their family, covering anticipated results, potential risks, and alternative therapeutic approaches. Additionally, the referring physician will receive regular updates regarding the treatment plan.
Nephrostomy
A nephrostomy catheter is a small drainage tube placed percutaneously (through the skin) into the kidney in order to allow urine to drain to the outside. This can be needed for several conditions, including blockage of the kidney or ureter by a stone or tumor or build-up of infected fluid in the kidney collecting system. Interventional Radiologists at Wake Radiology place nephrostomy catheters using image guidance such as ultrasound and fluoroscopy. The procedure takes place within the interventional radiology department, where patients receive local anesthesia and intravenous medications for conscious sedation. Once a nephrostomy catheter is in place, urine will drain to the outside of the patient into a drainage bag. Some patients with nephrostomy catheters require long-term urinary drainage and the tubes will require changing every nine to 12 weeks.
Nephroureteral catheter
A Nephroureteral catheter is similar to a nephrostomy catheter. A Nephroureteral catheter is a small drainage tube placed through a tiny incision in the skin directly into the kidney,. The catheter extends from the kidney down through the ureter, and then into the bladder. These tubes can be placed on a temporary basis, such as prior to stone removal by the Urologist. In this situation, they are placed by the Interventional Radiologist just before the patient goes to the operating room for stone removal. Different versions of the tube can be placed for a more permanent need, and these versions have holes allowing urine to drain either down into the bladder or into the drainage bag on the outside of the patient.
Ureteral stent
The ureter connects the kidney to the bladder. When a patient has a blockage of urine, depending on the situation, a ureteral stent can be placed. If a patient has nephrostomy access into the kidney, this tube can be converted to a ureteral stent by the Interventional Radiologist. Using local anesthetic and minimal IV sedation medication, guidewires and catheters are used to achieve access into the bladder. Once the ureteral stent is working, the patient will no longer require an external tube coming out through the skin.
Varicocele Embolization
Various treatments for varicoceles include both surgical and non-surgical options. Interventional Radiologists at Wake Radiology perform an embolization procedure to block the abnormal blood vessels which are causing the varicocele. This reduces the back pressure upon the scrotal veins, allowing them to heal. This minimally-invasive procedure is performed on an outpatient basis with less risk, less pain, and shorter recovery time compared to traditional surgery.
Nutritional needs
Some patients’ nutritional requirements are not able to be met by oral intake, either because of neurological dysfunction and discoordinated muscle control or by blockage from a tumor. Sometimes patients have difficulty with oral intake because of aspiration (food going into the airway) and are at risk for lung infection. In these situations, a percutaneous (through the skin) catheter such as a G-tube or GJ tube can be placed by our IR physicians at Wake Radiology.
Gynecologic Interventions
Consultation
At Wake Radiology, our Interventional Radiologists consult with patients to address their gynecologic symptoms and medical history, and also examine relevant imaging exams to establish the most suitable treatment strategies. Before embarking on any minimally-invasive procedure, our physicians engage in comprehensive discussions with both the patient and their family to outline expected outcomes, potential risks, and alternative therapeutic options. Furthermore, we ensure that the referring doctor remains informed about the treatment plan through regular updates.
Ovarian Vein Embolization
Pelvic Congestion Syndrome is a condition that predominantly affects women, causing chronic pelvic pain. It occurs when the veins within the pelvis, particularly the ovarian veins, become dilated and engorged with blood, leading to discomfort and pain. PCS can be a debilitating condition, impacting a person’s quality of life.
The interventional radiologists at Wake Radiology play a crucial role in diagnosing and treating PCS. Utilizing their expertise in image-guided procedures, interventional radiologists employ a technique known as ovarian vein embolization to accurately identify and target the root cause of pelvic pain, frequently arising from dilated ovarian veins.
Benefits of Ovarian Vein Embolization:
Minimally-invasive: Ovarian vein embolization is performed through a tiny incision, reducing the risk of complications and speeding up recovery.
High success rate: The procedure has a high success rate in relieving PCS symptoms, including pelvic pain and discomfort.
Minimal downtime: Patients typically resume their regular activities within a few days, enjoying a significant improvement in their quality of life.
How To Schedule: Call Wake Radiology’s Interventional scheduling department at 919-788-1916 to schedule a consultation regarding pelvic congestion syndrome treatment.
Uterine Artery Embolization for Uterine Fibroids
Uterine Artery Embolization / Uterine Fibroid Embolization (UAE/UFE) is performed to treat women with symptomatic uterine fibroids. Uterine fibroids are a common health issue among women, often causing discomfort, pain, and other troublesome symptoms. Fortunately, interventional radiologists offer an effective and minimally-invasive solution called uterine fibroid embolization (UFE).
Understanding Uterine Fibroids:
Uterine fibroids are benign growths that develop within the muscular walls of the uterus. These growths can vary in size and number, and while some women may not experience any symptoms, others may suffer from heavy menstrual bleeding, pelvic pain, and even fertility issues.
The Role of Interventional Radiologists:
The Interventional radiologists at Wake Radiology specialize in using advanced imaging techniques to guide minimally-invasive procedures. UFE is one such procedure that these experts perform to treat uterine fibroids effectively.
Benefits of Uterine Fibroid Embolization:
Non-surgical: UFE is a minimally-invasive procedure, eliminating the need for traditional surgery and its associated risks and recovery time.
Symptom relief: UFE effectively alleviates symptoms associated with uterine fibroids, including heavy menstrual bleeding and pelvic pain.
Preservation of the uterus: Unlike surgical options like hysterectomy, UFE allows women to retain their uterus and fertility potential.
How to Schedule: If you are experiencing the discomfort of uterine fibroids, consider consulting with a healthcare provider to explore the potential benefits of UFE as a treatment option. Call Wake Radiology’s Interventional scheduling department at 919-788-1916 to schedule a consultation regarding UFE.
Oncology Interventions
Consultation
At Wake Radiology, our Interventional Radiologists will meet with patients to discuss their symptoms and health history, as well as review any pertinent imaging prior to determining the best treatment options. Prior to any minimally-invasive procedure, the physician will discuss expected outcomes, risks, and alternative therapies with the patient and their family. The referring doctor will be updated regarding the treatment plan.
Biopsy
Many times patients are found to have findings on imaging studies that require further testing. A nodule or mass detected on imaging studies or felt by the patient’s doctor may need to be biopsied. Biopsies are performed so that the tissue can be analyzed by a pathologist under the microscope. Image-guided biopsies can be performed with ultrasound guidance, CT guidance, or fluoroscopic x-ray guidance. Many needle biopsies can be performed on an outpatient basis with local anesthetic.
Chemoembolization
Many patients with liver cancer may not be candidates for surgery and IV chemotherapy may not be effective. Interventional Radiologists play a role in the treatment of these patients by injecting medicines attached to microscopic particles directly into the blood vessels of the liver. In the Interventional Radiology suite, after local anesthetic and IV sedation medication is given, a thin catheter is advanced into the hepatic artery through a tiny puncture in the groin. This method allows for higher doses of medicine directly at the tumor site. Patients usually stay in the hospital overnight after the procedure and are discharged the next day.
Cryoablation
Certain tumors within solid organs can be treated with surgery. Other small tumors can be treated without the need for surgery using minimally-invasive techniques. Cryoablation therapy is a procedure that uses an extremely cold application directly into the tumor – permanently freezing and destroying cancer cells. Using imaging guidance such as CT, Interventional Radiologists insert a thin metal probe like a thick needle directly into the tumor of the sedated patients. Then, cycles of rapid freezing and thawing are performed to ensure the tumor is completely treated. This procedure is frequently performed on an outpatient basis without the need for a major surgery.
Microwave ablation
Certain tumors within solid organs can be treated with surgery. Other tumors that are small enough can be treated without the need for surgery using minimally-invasive techniques. Microwave ablation is a therapy that uses thermal energy heat to kill the tumor. Interventional Radiologists at Wake Radiology perform this procedure under imaging guidance such as CT. A thin metal antenna like a thick needle is directed into the tumor while patients are sedated. Then, electromagnetic energy is applied, creating heat within the tumor.
Selective Internal Radiation Therapy (SIRT)
Many patients with liver cancer may not be candidates for surgery, and IV chemotherapy may not be effective. Interventional Radiologists play a role in the treatment of these patients by performing Selective Internal Radiation Therapy (SIRT). SIRT (or radioembolization) involves injecting tiny radioactive particles directly into the blood vessels of the liver. These particles lodge in tiny blood vessels and emit radiation which kills the tumor. Careful mapping of the blood supply to the liver is needed, requiring a planning angiogram prior to the actual treatment day. On the treatment day, local anesthetic and a relaxing IV medication is given to the patient. Then the radiologist makes a tiny incision in the groin which provides access to one of the main arteries. A thin catheter is advanced into the artery and then to the hepatic artery that provides part of the blood flow to the liver. Then, microscopic radioactive particles are injected. These will admit radiation directly into the tumor and allow for a much higher dose of radiation than traditional radiation therapy.
Paracentesis
A paracentesis is a procedure performed to remove fluid from the abdominal cavity. Abdominal fluid may build-up due to a number of factors, including liver disease and cancer. In order to drain the fluid, imaging guidance is used. After sterile prep of the skin, skin is anesthetized or numbed. Using ultrasound guidance, a small catheter is inserted to gain access to the fluid. The fluid is drained and then sent to the lab for testing. A bandage is placed over the skin when finished.
Port Catheter
When chemotherapy, IV nutrition, or long-term IV antibiotics are needed, a port or other long-term venous access catheter is placed. Wake Radiology Interventional Physicians use imaging guidance and minimally-invasive techniques to place these catheters without the need for surgery. Patients are given local anesthetic and usually a relaxing medication. Through a small incision, the port is placed under the skin, usually in the right side of the chest. It is attached to a catheter (a thin, flexible tube) that is guided (threaded) into a large vein above the right side of the heart called the superior vena cava. A needle is inserted through the skin into the port to draw blood or give fluids and other treatments. The catheter may stay in place for many weeks, months, or years.
Thoracentesis
A thoracentesis is a procedure performed to remove fluid from around the lung. Fluid can build up around the lung due to any number of factors, including infection, cancer, or surgery. In order for the lung to re-aerate and allow patients to breathe easier, the fluid can be removed using imaging guidance. Once the fluid is localized under ultrasound guidance, the skin is sterilized and anesthetized or numbed. A small catheter is placed into the fluid using ultrasound guidance. The appropriate amount of fluid is removed. Some of the fluid may be sent to the lab for testing. Once the fluid is removed, a small bandage is placed, and a chest x-ray is usually performed.
Tunneled drainage catheter
The PleurX system is a method for removing fluid that continues to build up in the chest or abdomen on a regular basis. These catheters are placed by Interventional Radiologists under local anesthetic and IV medication for conscious sedation. The PleurX catheters are designed to be kept in place so that patients are able to drain the fluid from time to time at home without having to come to the hospital or office for drainage.
Pain Interventions
Consultation
At Wake Radiology, our Interventional Radiologists will meet with patients to discuss their symptoms and health history, as well as review any pertinent imaging prior to determining the best treatment options. Prior to any minimally-invasive procedure, the physician will discuss expected outcomes, risks, and alternative therapies with the patient and their family. The referring doctor will be updated regarding the treatment plan.
Kyphoplasty / Vertebroplasty
Many patients with osteoporosis who have suffered a vertebral compression fracture maybe candidates for a non-surgical minimally-invasive treatment to stabilize the fracture and alleviate pain. Interventional Radiologists at Wake Radiology will meet with patients who have suffered a vertebral compression fracture. Depending on patient conditions, timing of the fracture, and imaging appearance, the patient may be a candidate for a Kyphoplasty or Vertebroplasty procedure, either on an outpatient or inpatient basis. During the procedure, patients are sedated, and, through small punctures in the sterilized skin, thin metal tubes like large needles are inserted into the bone to the site of the fracture, using fluoroscopic x-ray guidance. With Kyphoplasty, a balloon is inflated to create a cavity in the bone, but with Vertebroplasty, no cavity is created. For both procedures, bone cement is injected into the site of the fracture, thereby stabilizing the bone. Many patients experience pain relief very quickly after the procedure, and outpatients are usually discharged several hours after the procedure.
Sacroplasty
Weakened bones in the back part of the lower pelvis near the tailbone may be prone to fractures, called sacral insufficiency fractures. The bone fragments in these fractures are not separated, but the fractures can cause significant pain. Similar to other minimally-invasive techniques in the spine, Interventional Radiologists can treat these fractures by infusing a bone cement to stabilize the fracture site. Patients are sedated for these procedures, and then using x-ray or CT guidance, thin metal tubes like large needles are inserted into the bone. Bone cement is injected and quickly hardens, stabilizing the fracture and alleviating the pain.
Radiofrequency (RF) Ablation
The majority of patients with cancer that has spread to the bones suffer with some degree of pain. When cancer has spread to the bones, treatment is focused on alleviating patients’ symptoms, rather than trying to cure the cancer. Radiation therapy provided by radiation oncologists is the standard treatment for painful bone tumors. However, sometimes radiation can no longer be given due to certain limitations. Interventional Radiologists can treat painful bone tumors with minimally-invasive image-guided techniques such as radiofrequency (RF) ablation. During RF ablation procedures, patients are sedated, and imaging guidance such a CT scanning is used to allow the Interventional Radiologist to position a probe (or thick needle) into the tumor. Radiofrequency energy is applied, thereby heating the tumor and killing tumor cells. If stabilization of the weakened bone is needed, a bone cement can be injected in conjunction with RF ablation to attempt to minimize the risk of a fracture later. RF ablation procedures are frequently performed on an outpatient basis, during which patients are discharged several hours after the procedure.
Other Services
Image-guided joint injections and other similar therapeutic and diagnostic procedures using fluoroscopic x-ray, ultrasound, and CT Imaging are performed by fellowship-trained board-certified Musculoskeletal Radiologists at Wake Radiology.
Vascular Interventions
Consultation
At Wake Radiology, our Interventional Radiologists meet with patients to discuss their symptoms and health history, as well as review any pertinent imaging prior to determining the best treatment options. Prior to any minimally-invasive procedure, the physician will discuss expected outcomes, risks, and alternative therapies with the patient and their family. The referring doctor will be updated regarding the treatment plan.
Angiography
Angiography is a method of medical imaging performed to analyze blood vessels. During a traditional angiogram, a contrast agent (x-ray dye) is directly injected into the blood vessels of interest and x-ray images are obtained so that the blood vessels are visible. The contrast agent is injected through a needle or tiny tube (catheter) into the blood vessel. The procedure is performed with local anesthetic and usually IV medication for conscious sedation. When non-invasive imaging is appropriate, angiographic images can be obtained with computed tomography (CTA) or MRI (MRA) techniques and performed at one of our Wake Radiology Imaging Centers.
When a blood vessel is blocked or narrowed by any of a number of conditions, that blood vessel can be re-expanded using a balloon, called angioplasty, improving blood flow to the tissues past the narrowing. A metallic stent can also be used to re-expand the blood vessel, and this stent stays in place after the procedure. Interventions such as angioplasty and stenting have replaced open surgery in many situations, leading to faster recovery times and decreased pain and discomfort.
When kidney failure requires that a patient receive dialysis treatments on a short-term or long-term basis, catheters can be placed in order to allow immediate access into the bloodstream for dialysis. Wake Radiology Interventional Physicians use imaging guidance and minimally-invasive techniques to place these catheters, without the need for surgery. Patients are given local anesthetic and usually IV medication for conscious sedation. The appropriate vein is chosen, and the catheter is placed so that the tip is in a large central chest vein (to accommodate rapid flow of blood from the dialysis machines).
When a blood vessel is bleeding or there is a need to decrease the blood flow to a certain organ or tissue in the body, Interventional Radiologists can use minimally-invasive image-guided techniques to stop the hemorrhage or decrease the blood flow. Wake Radiology IR physicians use a number of different materials or devices to perform an embolization, avoiding the need for an open surgery. As part of the procedure, an angiogram is performed in order to visualize the blood vessels, and then the appropriate device or material is injected in order to “plug up” the blood vessel.
When a patient suffers with a DVT (deep vein thrombosis – usually blood clots in the legs) but is unable to receive anticoagulants (blood thinners), an IVC filter can be placed. The IVC (Inferior Vena Cava) is the large vein in the abdomen through which blood travels from the lower limbs and pelvis back up to the heart. In order to protect the heart and lungs from blood clots traveling up from the legs, our Interventional Radiologists place a cone-shaped filter device into the IVC. Using minimally-invasive image-guided techniques, Wake Radiology’s IR physicians guide a small catheter less than 1/4 inch diameter through a small skin puncture into the appropriate vein. Once correctly positioned, the filter is released and stays in position in the body. It can be removed at a later date once the DVT has resolved or the patient can receive blood thinners.
Samples of tissue from the liver (biopsy) are frequently needed for diagnostic testing. However, it is sometimes unsafe to obtain these directly through the skin into the liver, because of high bleeding risk. In these cases, a biopsy of liver tissue can be obtained by accessing the liver through the internal network of blood vessels. Local anesthetic and IV conscious sedation are given during the procedure. Imaging guidance is then used to access a vein in the neck. Through this vein, a small sheath or tube is placed, and then, using fluoroscopic x-ray guidance, a biopsy device is advanced into the liver through the hepatic veins. Biopsy specimens are taken and sent to the pathology lab for analysis.
When chemotherapy, IV nutrition, or long-term IV antibiotics are needed, a port or other long-term venous access catheter is placed. This allows access to the bloodstream via the large central veins of the chest. Wake Radiology Interventional Physicians use image guidance and minimally-invasive techniques to place these catheters, without the need for surgery. Patients are giving local anesthetic and usually IV medication for conscious sedation. Ports are secured under the skin, with only a small incision visible. Other types of catheters extend out through the skin, able to be connected to IV medication infusion systems.
Pelvic Congestion Syndrome (PCS)
Pelvic Congestion Syndrome is a condition that predominantly affects women, causing chronic pelvic pain. It occurs when the veins within the pelvis, particularly the ovarian veins, become dilated and engorged with blood, leading to discomfort and pain. PCS can be a debilitating condition, impacting a person’s quality of life.
Interventional radiologists play a crucial role in diagnosing and treating PCS. They employ their expertise in image-guided procedures to precisely locate and address the underlying cause of the pelvic pain, which is often the dilated ovarian veins.
The Procedure:
Patient Evaluation:
The process begins with a thorough evaluation of the patient’s symptoms and medical history. Diagnostic imaging, such as ultrasound or CT scans, may also be used to confirm the diagnosis and pinpoint the problematic veins.
Local Anesthesia:
Before the procedure, the patient is administered local anesthesia to numb the area, ensuring minimal discomfort during the embolization.
Catheter Insertion:
A thin catheter is then inserted into a vein, typically through the groin or neck, and carefully guided to reach the affected ovarian veins.
Embolization:
Small particles or a specialized solution is injected through the catheter directly into the dilated ovarian veins. These particles block the blood flow in the affected veins, causing them to collapse and shrink.
Monitoring:
Throughout the procedure, real-time imaging, such as fluoroscopy or ultrasound, is used to ensure precise placement of the embolic material.
Recovery:
After the procedure, patients usually experience minimal discomfort and can often return home the same day or the following day.
Benefits of Ovarian Vein Embolization for Pelvic Congestion Syndrome:
Minimally-invasive:
Ovarian vein embolization is performed through a tiny incision, reducing the risk of complications and speeding up recovery.
High success rate: The procedure has a high success rate in relieving PCS symptoms, including pelvic pain and discomfort.
Minimal downtime:
Patients typically resume their regular activities within a few days, enjoying a significant improvement in their quality of life.
Call Wake Radiology’s Interventional scheduling department at 919-788-1916 to schedule a consultation regarding pelvic congestion syndrome treatment.
Tissue Diagnosis
In order to further evaluate an abnormal imaging finding, patients require a sampling of tissue from a specific site in the body. This may be very deep in the body or may be close to the skin (superficial). Regardless of location, Wake Radiology Interventional Physicians use advanced imaging techniques such as CT scanning or ultrasound and a minimally-invasive approach in order to retrieve tissue for analysis in the most pain-free way possible.
Uterine Fibroids
Uterine Artery Embolization
Uterine Artery Embolization / Uterine Fibroid Embolization (UAE/UFE) is performed to treat women with symptomatic uterine fibroids. Uterine fibroids are a common health issue among women, often causing discomfort, pain, and other troublesome symptoms. Fortunately, interventional radiologists offer an effective and minimally-invasive solution called uterine fibroid embolization (UFE).
Understanding Uterine Fibroids
Uterine fibroids are benign growths that develop within the muscular walls of the uterus. These growths can vary in size and number, and while some women may not experience any symptoms, others may suffer from heavy menstrual bleeding, pelvic pain, and even fertility issues.
The Role of Interventional Radiologists
The Interventional radiologists at Wake Radiology specialize in using advanced imaging techniques to guide minimally-invasive procedures. UFE is one such procedure that these experts perform to treat uterine fibroids effectively.
The UFE Procedure
Patient Evaluation: The process begins with a thorough evaluation of the patient’s medical history and symptoms. Imaging studies, such as MRI or ultrasound, may be used to assess the size, location, and number of fibroids.
Local Anesthesia: Prior to the procedure, the patient is given local anesthesia to numb the area, ensuring minimal discomfort during the embolization.
Catheter Insertion: A small incision is made, typically in the groin, and a thin catheter is inserted into an artery. Guided by real-time X-ray imaging (fluoroscopy), the catheter is threaded into the uterine arteries that supply blood to the fibroids.
Embolization:Tiny particles, often made of a biocompatible material, are injected through the catheter and into the uterine arteries. These particles block the blood flow to the fibroids, causing them to shrink and die.
Monitoring: Throughout the procedure, the interventional radiologists at Wake Radiology use continuous imaging to ensure precise placement of the embolic material and to monitor the progress of the treatment.
Recovery: After the procedure, patients typically experience a relatively short recovery period. Most can return home the same day.
Benefits of Uterine Fibroid Embolization:
Non-surgical: UFE is a minimally-invasive procedure, eliminating the need for traditional surgery and its associated risks and recovery time.
Symptom relief: UFE effectively alleviates symptoms associated with uterine fibroids, including heavy menstrual bleeding and pelvic pain.
Preservation of the uterus: Unlike surgical options like hysterectomy, UFE allows women to retain their uterus and fertility potential.
If you are experiencing the discomfort of uterine fibroids, consider consulting with a healthcare provider to explore the potential benefits of UFE as a treatment option.
Call Wake Radiology’s Interventional scheduling department at 919-788-1916 to schedule a consultation regarding UFE.
Learn more about UFE
Varicocele
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Port Catheter
When chemotherapy, IV nutrition, or long-term IV antibiotics are needed, a port or other long-term venous access catheter is placed. Wake Radiology Interventional Radiologists use image guidance and minimally-invasive techniques to place these catheters without the need for surgery. Patients are given local anesthetic and usually a relaxing medication during the procedure. Through a small incision, the port is placed under the skin, usually in the right side of the chest. It is attached to a catheter (a thin, flexible tube) that is guided (threaded) into a large vein above the right side of the heart called the superior vena cava. A needle is inserted through the skin into the port to draw blood or give fluids and other treatments. The catheter may stay in place for many weeks, months, or years.
Interventional Studies
Quality Imaging is Expertise
Our interventional radiologists are board-certified fellowship-trained physicians and specialize in minimally-invasive image-guided targeted therapies in order to treat a vast array of medical conditions in virtually all organ systems of the body.
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