Appointments:  919.232.4700

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Interventional Radiology

Our comprehensive services for Interventional Radiology are offered in a convenient, outpatient center. Our subspecialists in vascular and interventional imaging provide an unusually extensive depth of expertise that ranges from conventional techniques to advanced imaging protocols. With over 50 years of combined experience in vascular and interventional medicine, our board-certified physicians specialize in a wide range of procedures. Learn about the interventional radiology procedures.

Sub-specialist in Interventional Radiology

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. Each of our interventional radiologists are able to apply expertise with medical imaging (x-ray, ultrasound, CT, and MRI) in order to perform the least invasive treatment possible in order to diagnose and treat various conditions. Wake Radiology Interventional Physicians have undergone extensive training, at least six years after medical school, gaining expertise in both diagnostic imaging and image-guided procedures. 

Ashley E. Bragg, PA

Interventional Radiology PA

Raj Gondalia, MD

Interventional Radiologist

Michael D. Kwong, MD

Vascular and Interventional Radiologist

Peter L. Leuchtmann, MD

Vascular and Interventional Radiologist, Musculoskeletal Radiologist, Co-director of Interventional Services

Matthew D. Miller, MD

Interventional Radiologist

Carroll C. Overton, MD

Vascular and Interventional Radiologist, Co-director of Interventional Services

Thomas L. Presson Jr., MD

Vascular and Interventional Radiologist, Breast Imaging Specialist

Philip C. Pretter, MD

Vascular and Interventional Radiologist, Breast Imaging Specialist

Convenient Office Locations

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.

Common Conditions We Treat

 

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. For many years, these fractures have been treated only with pain medication and back braces, and patients had to wait until they eventually heal. During that convalescent time, however, patients can become more debilitated with their decreased activity and also suffer from side effects of the pain medication. Now, compression fractures can be treated by our Interventional Radiologists using minimally-invasive techniques, including Balloon Kyphoplasty and Vertebroplasty. Sacroplasty can be used to treat some fractures in the sacrum.

DVT / PE (Deep Vein Thrombosis / Pulmonary Embolus)

Patients with a blood-clotting disorder or prolonged period of immobility are at risk for forming blood clots, usually in the veins of the lower limb. When blood clots break loose and travel through the veins into the heart and lungs, this results in a pulmonary embolus, which can be serious and even life-threatening. Blood thinning agents (anticoagulants) are typically used to treat patients with DVT (deep vein thrombosis), although some people may not be able to tolerate those medications. In some situations, an IVC filter may be placed to protect the lungs from clots breaking loose. Some DVT can severely block flow through veins in the lower legs, in which case more aggressive treatment such as clot removal or clot dissolving medication may be needed.

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.

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.

Pelvic Congestion Syndrome (PCS)

Varicose veins deep within the pelvis can be associated with chronic pelvic pain, which can be debilitating for some female patients. These blood vessels fill with blood, becoming engorged and swollen, leading to patients’ symptoms. Certain patients may be a candidate for an ovarian vein embolization by one of our Interventional Radiologists. This procedure helps block the flow of blood through these swollen abnormal vessels, relieving the pain symptoms.

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 are able to 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 fibroids are very common benign tumors within the uterus. Fibroids in most women are typically small and do not cause any issues. However, some women have fibroids that are larger and can cause a variety of symptoms. These symptoms include heavy bleeding or bleeding between periods, which can lead to anemia (fewer red blood cells) and fatigue. Other symptoms include pain and pressure in the pelvis, bladder pressure, pressure on the bowel, and pain during intercourse.  Our Interventional Radiologists at Wake Radiology can treat uterine fibroids with a minimally-invasive non-surgical procedure called UAE / UFE (Uterine Artery Embolization / Uterine Fibroid Embolization).

Varicocele

An abnormally dilated network of veins in the scrotum is referred to as a varicocele. This can be due to lack of normally functioning valves, which are supposed to ensure that blood only flows in one direction. When the valves are not functioning appropriately, venous blood builds up in the scrotal veins. This can lead to symptoms of scrotal pain, testicular shrinkage, and even infertility problems. Surgical and non-surgical treatment options are available. Interventional Radiologists at Wake Radiology perform a minimally-invasive non-surgical treatment call varicocele embolization. During the procedure, the abnormal blood vessels are occluded (blocked), reducing pressure on the varicocele, and allowing it to heal.

Varicose Veins

Varicose veins are an extremely common condition, affecting 2 out of 5 women and 1 out of 4 men. When the one-way valves in the veins of the lower extremities fail to function normally, blood backs up in the lower extremity veins, causing them to dilate and remain filled with blood. In addition to an unsightly appearance, varicose veins may cause sensations of pain or achiness, heaviness, throbbing, and burning or tingling. Call 919-788-1916 to schedule your consultation with one of our vein experts at Wake Radiology Interventional Services. Various treatment options exist, including microphlebectomy, sclerotherapy, and EVLT.

Vascular access

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.

Venous Insufficiency

The flow of circulating blood through the body is assisted by valves in the veins, which function to direct the flow of blood back to the heart. When these valves “leak” or are insufficient/incompetent, blood backs up and is stagnant in the veins. This can lead to symptoms of pain, swelling, varicose veins, skin changes, and even skin ulcers. Symptoms may progress if treatment is delayed. Call 919-788-1916 to schedule your consultation with one of our vein experts at Wake Radiology Interventional Services. Treatment options are available, including EVLT.

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