COST-EFFECTIVE CAREQuality outcomes for quality of life. All Wake Radiology interventional patients are seen, evaluated and treated by one of our board-certified interventional physicians — regardless of the procedure.
Our vascular and interventional radiologist provide an extensive depth of expertise that ranges from conventional techniques to advanced imaging protocols.
Our Interventional Radiologists partner with physicians in many medical and surgical specialties in order to determine the most appropriate diagnostic or therapeutic treatment option for patients. Interventional radiologists will meet with a patient and discuss the treatment options available. After the patient is examined and appropriate imaging and/or lab tests are performed, the patient and his/her IR specialist will decide on therapy. During IR procedures tiny medical devices such as catheters, wires, and other micro-instruments are guided through the body under imaging guidance, usually through a tiny puncture in the skin about the size of a pen tip. By performing procedures in this manner, patients will experience less pain, lower risks, quicker recovery time, and lower costs compared to traditional surgeries.
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The Wake Radiology outpatient Interventional Radiology office is located at 4301 Lake Boone Trail, across the street from Rex Hospital. Some of our procedures are performed in this office. Inpatient procedures and some of our more involved outpatient procedures are performed at Rex Hospital. Pre-procedure consultation for outpatients and post-procedure follow-up visits will occur at our outpatient office.
Wake Radiology Interventional Physicians are available for consultation on an inpatient and outpatient basis. Outpatients may schedule a consultation with us at our outpatient office by calling 919-788-1916 or having their referring provider schedule an appointment. Referring providers with inpatients who may need one of our services may contact us in the hospitals we staff.
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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.
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 the 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 vessels of Interest. The procedure is performed by our Wake Radiology IR physicians with local anesthetic or numbing medicine at the skin and usually IV medication for conscious sedation. When non-invasive imaging is appropriate, angiographic images can be obtained with CT scanning (called CTA) or MRI (called MRA) techniques and performed at one of our Wake Radiology Imaging Centers, supervised and interpreted by our diagnostic radiologists.
Angioplasty / Stent
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.
Endovenous Laser Treatment (EVLT)
There are several options for treating venous insufficiency, which can be the source of varicose veins in the lower limbs. Minimally-invasive endovenous techniques, specifically EndoVenous Laser Treatments (EVLT), have largely replaced higher risk surgical procedures, such as vein stripping. The thin EVLT probe is placed into the vein under ultrasound guidance. Then, laser energy is activated in the probe to cauterize and seal the entire vein. Our Interventional Radiologists can perform EVLT procedures in our outpatient office with minimal sedation medication and local anesthesia to numb the tissues.
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 can 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.
Several treatments for varicose veins exist, including removal of the unsightly veins. With microphlebectomy, after skin and tissues are anesthetized, tiny cuts in the skin near the veins are made. Then, small instruments are used to remove the abnormal veins. This procedure is part of comprehensive vein care provided by Wake Radiology’s Interventional Vein Specialists.
One treatment method for eliminating varicose veins and spider veins is sclerotherapy, using an FDA-approved chemical agent to close up the abnormal veins. In this procedure, a tiny needle is used to inject the chemical directly into the veins. The vein walls seal together, and no more blood can fill into the bulging veins. Wake Radiology’s Interventional Physicians perform this procedure on an outpatient basis at our IR office.
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.
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 into the bloodstream in the large central veins of the chest. Wake Radiology Interventional Physicians use imaging 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. The appropriate vein is chosen, and the catheter is placed with the tip in a large central vein. 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.
Sometimes, blood from very specific veins deep within the body, such as the adrenal veins, is needed to be tested in order to assess for overproduction of certain hormones. Wake Radiology IR physicians are able to carefully maneuver tiny micro catheters (thin medical tubes) deep into the body using fluoroscopic x-ray guidance, through only a tiny skin puncture. These catheters are guided through the body’s veins, and then blood is removed from the appropriate vein deep in the body for testing.
Venography is a specific type of angiography during which only the veins are imaged. During a traditional venogram, a contrast agent (x-ray dye) is directly injected into the veins of interest, and the x-ray images are taken so that the veins can be seen. The contrast agent is injected through a needle or tiny tube (catheter) into the veins of Interest. The procedure is performed by our Wake Radiology IR physicians with local anesthetic or numbing medicine at the skin and usually IV medication for conscious sedation. When non-invasive Imaging is appropriate, venography images can be obtained with CT scan (called CTV) or MRI (called MRV) techniques and performed at one of our Wake Radiology Imaging Centers, supervised and interpreted by our diagnostic radiologists.