• Interventional Radiology

  • Interventional radiology is a specialty of radiology in which image-guided procedures are used to nonsurgically diagnose and treat a wide range of diseases. Interventional radiologists are board-certified physicians who specialize in these minimally invasive procedures.

    Interventional radiologists thread narrow tubes, or catheters, through the body's arteries and organs. At every step, they use the images from X-rays, CT scans, ultrasounds, MRIs, and other imaging devices to direct their work. This allows the interventional radiologist to open blocked blood vessels, drain obstructions obtain biopsies and perform many other procedures. Interventional radiology is one of the most rapidly advancing areas of medicine.

    Interventional Radiology in Littleton Colorado

    Interventional radiology treatments offer less risk, pain, and recovery time compared with traditional surgery. What previously required a trip to the operating room and several days in the hospital now can often be accomplished in a few hours, thanks to interventional radiology.

    The five most important benefits to an interventional radiology procedure are:

    • less trauma to the body
    • less anesthesia
    • quicker recovery
    • shorter hospital stay
    • less pain

    What is the difference between an interventional radiologist and a traditional radiologist?

    A traditional "diagnostic" radiologist uses imaging devices to rule out or uncover a problem, and then turns his findings over to another specialist. An interventional radiologist is trained to treat most of the diseases he will discover. As the treating physician, the interventional radiologist works closely with the patient, explaining and performing the procedure, handling any unexpected events, and providing follow up care with the patient. 

    Why come to Littleton Adventist Hospital for your interventional radiology procedure?

    Littleton Adventist Hospital offers a wide array of advanced interventional radiology treatments. We have built a unique environment that supports collaboration among many types of specialists to deliver the most innovative and highly specialized services for our patients.

    Our board-certified interventional radiologists come from the nation's most respected training programs and universities. Many of them are nationally recognized experts.

    Read more about the conditions being treated with interventional radiology and the many available procedures .

  • Conditions treated through interventional radiology
    Interventional radiology uses minimally invasive medical technology to treat a wide variety of conditions and disease states. Some of these include:

    • Cancer: Many new ways of treating cancer tumors are now being performed. Working with the oncology team, interventional radiologists use minimally invasive procedures to block off (embolize) blood vessels that are feeding a tumor, or they can insert chemotherapy and radiation directly to the tumor.
    • Clogged Arteries: Interventional radiologists use a technique called balloon angioplasty to unclog arteries anywhere in the body, including the legs, kidneys or arteries leading to the brain.
    • Heart Disease: Interventional radiologists perform diagnostic tests, such as angiography to help pinpoint heart conditions. They can also perform angioplasty or insert stents to open clogged arteries.
    • Gynecological Conditions: Chronic pelvic pain and uterine fibroids are two of the most common female conditions that can now be helped with minimally invasive procedures that cut off the blood supply to the pain-causing veins or arteries.
    • Leg Pain: Minimally invasive treatments are now commonly used to treat many different types of leg pain, including varicose veins, blood clots in the leg arteries and claudication, a pain that occurs in the legs when walking or exercising.

    The highly trained and respected interventional radiologists at Littleton Adventist Hospital offer a broad spectrum of interventional radiology procedures and treatments. Utilizing the latest advances in medical technology, they are able to perform minimally invasive procedures that provide our patients with faster recoveries than traditional surgery.

    Here is a brief overview of the most common interventional radiology procedures.

    Abdominal Aortic Aneurysm Stent - Aneurysms are created when the wall of a blood vessel has weakened, filled with blood, and bulges out. Aneurysms most commonly occur in the abdomen or chest areas. An interventional radiologist, working with a vascular surgeon, can place a stent into the aneurysm, cutting it off from the blood circulation.

    Angiography - An x-ray of the arteries and veins to locate and diagnose blockages and other blood vessel problems. The interventional radiologist may also use a catheter to enter the blood vessel and a contrast agent, or x-ray dye, to make the artery or vein visible on the x-ray.

    Angioplasty - Opening blocked or narrowed blood vessels by inserting a very small balloon into the vessel and inflating it. This procedure allows the interventional radiologist to unblock clogged arteries in the legs or arms (referred to as peripheral arterial disease or PAD), kidneys, brain or other parts of the body.

    Biliary Drainage - Biliary drainage is a minimally invasive procedure in which backed up bile, a liquid released by the liver to aid in digestion, is drained from the liver through a catheter.

    Blood Clot Embolization - Embolization can be used to dissolve or eradicate blood clots in the legs. When patients have recurrent blood clots, pieces (emboli) may float through the heart and lodge in the lungs. This potentially serious problem can be treated by placing a filter into the large vein that carries blood directly to the heart.

    Catheter Insertions - A catheter, or small tube, is inserted into large veins for giving chemotherapy drugs, nutritional support, and hemodialysis. A catheter may also be inserted prior to bone-marrow transplantation.

    Chemoembolization - Cancer of the colon or other gastrointestinal tract tumors may "seed" the liver with tumor cells. Surgery may not be a good option for removing these cancer cells because they are distributed through the liver. Interventional radiologists perform chemoembolization by injecting an anticancer drug into the blood vessel that is feeding the tumor. This concentrates the chemotherapy near the tumor and spares other organs.

    Deep Vein Thrombosis - This procedure is designed to rapidly break up a clot in the leg, restore blood flow within the vein and potentially preserve valve function to minimize the risk of post-thrombotic syndrome.

    Intravascular Ultrasound - The use of ultrasound inside a blood vessel to better visualize the interior of the vessel in order to detect problems inside the blood vessel.

    Needle Biopsy - A small needle is inserted into the abdominal area in almost any part of the body, guided by imaging techniques, to obtain a tissue biopsy. This type of biopsy can provide a diagnosis without surgical intervention.

    Nephrostomy Drainage - Used to drain urine from the kidneys in the advent of blockage.

    Percutaneous Cryoablation - Use of extreme cold to destroy tumors.

    Port Placement - Ports provide access to the central vein system. They are placed in patients to more easily administer fluids and medications. One common use is to administer chemotherapy to cancer patients to avoid irritating the veins and also to make it more comfortable to patients who avoid multiple needle insertions.

    Radiofrequency Ablation - One of several types of ablation therapy, this technique uses high-frequency electrical energy to eliminate cancer tumors, painful varicose veins or other conditions.

    Sialogram - Used to obtain an x-ray image of the salivary ducts and related glandular structures.

    SIR Spheres® - Radioactive spheres are inserted into the hepatic artery that feeds the tumor.

    Stent Placement - Stent grafting places a tube, called a stent, into large blood vessels, when an aneurysm (a weakness in the vessel wall) is at risk of rupturing and causing fatal bleeding. The stent graft procedure offers a highly successful alternative to surgery and minimizes the risk of aneurysm rupture.

    Uterine Fibroid Embolization - The interventional radiologist blocks both uterine arteries, carrying the blood to the fibroids, by a targeted injection of fine particles. This results in shrinkage of the fibroids and disappearance of symptoms such as bleeding and pelvic pressure. For many women, this procedure may replace a hysterectomy.

    Varicocele Embolization - Varicose veins in the testicles and scrotum are traditionally treated with surgical ligation. This interventional radiology procedure is a nonsurgical procedure that blocks, or embolizes, the blood flow into the vein that is causing problems. This procedure has less risk, less pain and less recovery time than traditional surgery.

    Yttrium 90 Microsphere Embolization - This procedure is a specialized therapy for liver cancer patients. The radioactive isotope Y-90 is combined into microscopic spheres that deliver radiation directly to the tumor, allowing for higher doses of radiation without hurting healthy tissue. An interventional radiologist injects these microspheres through a catheter into the artery supplying blood to the tumor. The beads become lodged within the tumor vessels where they exert their local radiation to cause tumor cell death.

    You can also learn more about interventional radiology at The Society for Interventional Radiology.

     

    Venous reconstruction is a surgical procedure to reconstruct a weakened or damaged vein. The procedure is most often used to treat venous insufficiency, a chronic condition in which a vein has problems sending blood from the legs to the heart. The problem arises as a result of a weakened vein wall or leaking valves. Over time venous insufficiency may lead to a potentially life-threatening condition called deep vein thrombosis (DVT).

    DVT is a blood clot (thrombus) that forms in a large, deep vein, usually in your lower leg, thigh, or pelvis. This blood clot can break off and travel through the blood stream. If the loose clot (embolism) travels to your lungs, brain or heart, it can cause serious damage or death. For this reason, if you suffer from chronic, serious venous insufficiency or chronic DVT, your doctor may recommend venous reconstruction to address the underlying cause.

     In addition to DVT, venous insufficiency can lead to ulcers within the veins. Most ulcers heal quickly after superficial vein surgery, but if the ulcers are deep within the vein, treatment to correct the insufficiency may be recommended. To reconstruct a faulty valve causing venous insufficiency, your radiologist uses advanced X-ray imaging technology to maneuver a tiny (catheter) tube outfitted with surgical tools through a small incision in the vein near the damaged or weakened valve.

    Several techniques exist to reconstruct ineffective valves, including suturing a fold into the external wall of the vein or wrapping it in a sleeve or band. Both procedures are performed to decrease the diameter of the vein to improve venous flow. Venous reconstruction may require an overnight stay in the hospital, although some patients return home the same day.

    Before venous reconstruction became available, venous insufficiency treatment focused primarily on lifestyle changes, such as wearing compression stockings, not sitting for long periods, quitting smoking, and losing weight.

    Risk factors for venous insufficiency may include:

    • Age sixty and above
    • Obesity
    • Sitting, standing, or bed rest for extended periods
    • Pregnancy
    • Female (related to the hormone progesterone)
    • Being tall
    • Recent surgery
    • History of DVT or venous insufficiency

    Symptoms of venous insufficiency may include:

    • Cramping in legs, dull aching legs
    • Itching and tingling
    • Slow healing wound on the legs or ankles
    • Thick, hard skin on the legs and ankles
    • Red legs and ankles
    • Pain exacerbated by standing
    • Pain improves when legs are raised
    • Swollen legs and ankles (edema)
    • Skin color changes around the ankles
    • Varicose veins
    • Ulcers on legs and ankles

    Diagnosis of Venous Insufficiency:

    To diagnose venous insufficiency, your doctor will ask about your symptoms and take a detailed medical history. He or she will also perform a physical exam to look at your leg veins when you are standing and sitting with your legs dangling. A duplex ultrasound exam of your leg may also be recommended to check blood flow in the veins and rule out other problems, such as a blood clot.

    Deep Vein Thrombosis Clots

    Before venous reconstruction became available, anticoagulants (blood thinners) were often the standard of care for people with deep vein thrombosis (DVT). Blood thinners gradually dissolve the clot but don’t get rid of it completely. In the case of chronic, serious blood clots, your doctor may recommend venous reconstruction to completely remove the clot and repair the vein at the surgical site. The rationale for removing the clot is two-fold: to eliminate the obstruction and to preserve valve function.

    To remove the clot and repair the valve, your radiologist uses advanced X-ray imaging technology to maneuver a tiny tube (catheter) through a small incision in the vein near the clot. The radiologist opens the vessel to physically remove the clot rather than dissolve it. After removing the clot, your doctor may reconstruct the valve. This often involves attaching a small piece of artery to reroute blood flow to an area that has been prepared with stents, temporary tubes placed in the blood vessel to lend support. An interventional radiology procedure called balloon angioplasty may also be used to open blood vessels by inserting tiny surgical balloons.

    Preventive measures for DVT include:

    • Wearing compression stockings
    • Moving your legs often during extended travel or bed rest
    • Taking prescription anticoagulants (blood thinners)
    • Quitting smoking
    • Losing weight if you are obese

    Risk factors for DVT may include:

    • Sitting, standing, or bed rest for extended periods
    • A pacemaker catheter used in the groin vein
    • Giving birth in last six months
    • Age sixty and above
    • Obesity
    • Recent surgery, such as knee, hip, or female pelvic surgery
    • Having cancer
    • Having congestive heart failure
    • Family history of DVT 

    Symptoms of DVT may include:

    DVT primarily affects the large veins in the lower leg and thigh, almost always on one side of your body and may include:

    • Redness of skin
    • Leg pain
    • Leg swelling (edema)
    • Warmer skin in the affected area

    Diagnosis of DVT:

    To diagnose DVT, your doctor will conduct a physical exam, ask about your symptoms, and take a detailed medical history. He or she may also order a D-dimer blood test to detect small protein fragments that are present after a blood clot degrades and a Doppler ultrasound exam to measure the blood flow in the major arteries and veins of your legs.

    If ongoing treatment has not been successful in treating serious, chronic venous insufficiency or DVT, your doctor may recommend venous reconstruction to address the underlying problem. Your doctor will talk to you about all of your treatment options and explain the venous reconstruction procedure in depth to make sure it is right for you.

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