Specialized Vascular and Interventional Radiology Procedures

Endoscopes are long, narrow tubes with cameras at the end. They are typically used in the gastrointestinal (GI) or genitourinary (GU) systems to help doctors view internal structures that usually cannot be seen without surgery.

Interventional radiologists may use endoscopes and other instruments to treat difficult cases of gallstones, also known as cholelithiasis or choledocholithiasis. Endoscopes may also be used to take biopsies (tissue samples) in hard-to-reach areas of the body, such as the biliary system or gallbladder. In some cases, interventional radiologists use them to help place GI tubes.

Some medical conditions or injuries cause life-threatening bleeding that requires urgent medical care to stop it. Examples of events that may result in significant bleeding include: 

• Trauma 
• Postpartum hemorrhage (PPH)  
• Gastrointestinal (GI) bleeding  
• Severe hemoptysis (bleeding of the lungs or bronchial artery) 
• Complications following a surgical procedure 

If a patient has abnormal, heavy bleeding, interventional radiologists can use endovascular techniques to find the source of the bleeding. Then, they embolize (block) the blood vessel to stop the bleeding. 

Peripheral arterial disease (PAD) occurs when arteries become too narrow or blocked. Usually caused by atherosclerosis (accumulation of plaque and fatty deposits inside the arteries), this condition results in decreased downstream blood supply. 

PAD usually affects the lower body and legs. Common symptoms include skin wounds (ulcers) which may become infected, pain during rest and activity, tissue death, hair loss or impotence. 

Interventional radiologists use image-guided endovascular techniques to diagnose and effectively treat PAD. Typically, interventional radiologists access an artery at the wrist or groin. Then using small wires and catheters (thin tubes), they can identify and treat the diseased area. Common PAD procedures include balloon angioplasty (opening a narrowing), stent (tube) placement, atherectomy (removal of plaque from inside a blood vessel) or thrombectomy (blood clot removal). These procedures are often used together to help restore and maintain the arterial flow and improve your symptoms.  

Aneurysms occur when a section of an artery becomes abnormally wide. In many cases, aneurysms develop due to underlying conditions, such as atherosclerosis (buildup of plaque and fatty deposits inside the arteries). In other cases, infections or trauma may cause an aneurysm. 

The area of the artery experiencing an aneurysm may be weaker compared to normal artery wall. As a result, aneurysms may rupture, which could result in life- or limb-threatening bleeding.  

Using an image-guided endovascular procedure, specialists enter an artery at the wrist or groin. Then, they guide catheters (thin tubes) and wires to the aneurysm. To treat the aneurysm, they may deliver embolization (blocking) materials and/or stents (tubes). 

Throughout the body, hormones act as chemical and molecular messengers. A large variety of medical conditions result from organs producing hormones at levels that are too high or too low. 

Diagnosing some hormonal issues requires venous sampling, or examining blood from a specific vein. During this procedure, interventional radiologists use endovascular techniques to remove the blood sample from a very specific location. Then, laboratory specialists evaluate the sample to help make an accurate diagnosis. 

We commonly collect venous samplings from various parts of the body, including veins near the adrenal glands, liver (hepatic veins), ovaries, neck (parathyroid glands) and the brain (pituitary gland). 

In some cases, medical devices, implants or other objects end up in unexpected areas of the body and must be removed. Interventional radiologists may assist with foreign body retrieval with image guidance using specialized tools, like snares or forceps, that can grasp the foreign body. 

Endovascular stents (small tubes placed inside an artery) help manage aneurysms (enlarged artery). These are commonly used in treatment of aortic aneurysms. Typically, the stent excludes (blocks off) the aneurysm creating a narrower but stronger path for the blood to flow. An endoleak occurs if blood continues to fill in the excluded (blocked off) aneurysm sac. Complications of an endoleak may be life-threatening if the stent fails or the aneurysm ruptures. 

Interventional radiologists use imaged-guided techniques to evaluate the function of endovascular stents. If an endoleak is seen, they use endovascular techniques to embolize (block) the affected area to stop the leak.  

The thyroid gland makes hormones and is very prone to having abnormal growths with in it, or thyroid nodules. Often times, they are not functional or do not cause any problems (but can become large and cause cosmetic problems). Sometime nodules become problematic and cause hormone imbalances. Traditional approach to treatment is surgical (sometimes radioactive iodine, another radiology procedure from Nuclear Medicine). Thyroid nodule radiofrequency ablation is a percutaneous procedure (tiny poke through the skin) where a small slender probe/device is inserted in to the a thyroid nodule and it's heated up to destroy the abnormal tissue.