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Interventional radiology is a field of medicine in which minimally invasive procedures are performed using image guidance. Interventional radiology is one of the biggest advances in the medical field, offering treatments with less risk and less pain and shorter hospital stays than surgery. Vascular and interventional radiology is one of the most rapidly expanding areas in medicine and has led the current movement toward minimally invasive therapy. Our patient population ranges from infancy to the elderly and includes procedures spanning the full range of the field.
During most procedures, an interventional radiologist will use different imaging methods (e.g., CT, fluoroscopy, ultrasound) to direct a thin wire and catheter through a specific location in the body to treat or diagnose disease. With the use of different imaging methods, our interventional radiologists are able to manipulate and guide tiny instruments throughout the body, without the need for surgical incisions.
Interventional radiologists are board-certified physicians who are trained in both medical imagining and minimally invasive therapies. They deliver accurate, targeted treatments to complex and sometimes life-threatening diseases and conditions. Interventional radiology is a treatment option for conditions such as cardiovascular disease, stroke, cancer, uterine fibroids, varicose veins and many other common medical issues.
Advancements in technology and imaging have created new treatment options for patients. There is no “right way” to treat your condition. If you are a candidate for open surgery of have a complex disease, consider exploring your treatment options with an interventional radiologist. Interventional radiology can be an especially appropriate choice for patients who are in weak health or have previously undergone numerous prior surgeries.
Median arcuate ligament syndrome (MALS) occurs when the celiac artery (the artery below that diaphragm that stems from the aorta) becomes compressed by the median arcuate ligament. When the median arcuate ligament is restricted, the blood flow is limited to the digestive system which can ultimately lead to significant abdominal pain. This is treated by surgically releasing the median arcuate ligament to restore blood flow. In some instances, additional arteriography (mapping of the blood vessels using x-ray dye) or angioplasty (opening the artery with a balloon) may be needed.
Hereditary hemorrhagic telangiectasia (HHT) is a genetic disorder that causes malformed blood vessels and can affect multiple organs of the body. Arteriovenous malformation (AVM) occurs most commonly in the lung and, if left untreated, can lead to shortness of breath, brain abscesses or even stroke. To prevent these complications, an embolization procedure can be performed to cut off blood flow to these AVMs.
Prostate artery embolization (PAE) is a minimally invasive procedure for the treatment of an enlarged prostate. The procedure is performed through a small nick in your upper thigh or wrist to gain access to your arterial system. Using x-ray guidance, an interventional radiologist guides a catheter (a small hollow tube) to the vessels that supply blood to your prostate. Tiny particles are then injected through the catheter and into these blood vessels to decrease blood flow to your prostate. This causes the prostate to shrink and improves your urinary symptoms.
Healthy kidneys clean your blood and remove extra fluid in the form of urine. Dialysis replaces some of these functions when your kidneys no longer work. During hemodialysis, blood is removed from the body, filtered through an artificial kidney machine and then returned to the body. In order to perform hemodialysis, there needs to be proper access to the blood vessels.
An arteriovenous fistula is the preferred vascular access option for patients undergoing long-term hemodialysis. Fistulas are artificial connections between an artery and vein in your arm. Traditionally, fistulas are created by a vascular surgeon in an operating room. Advances in technology have now allowed for minimally invasive fistula creation using tiny catheters and wires, and without the need for any incisions.
A fistulogram or graft check is a procedure that uses contrast (x-ray dye) to look at the blood flow in your fistula or graft. This procedure can check to see if it there is any vessel narrowing or blockage. Vessels that are narrowed can be reopened to their optimal size using balloons or even small metal tubes (stents). If your fistula or graft is filled with clots, a declot procedure can be done to remove the clot and restore blood flow.
Having adequate vascular access is a critical lifeline for patients who are on hemodialysis. Unfortunately, some patients who are on long-term hemodialysis can develop severe scarring and blockage of the central veins in the chest and abdomen. Not only can this prevent adequate hemodialysis, but it can also cause pain and swelling of the arms, legs or head & neck. Using advanced techniques and equipment our interventional radiologists can reopen blockages and even reconstruct the major veins to restore proper blood flow.
Transjugular liver biopsy is an alternative to traditional biopsies of the liver that are performed through the abdomen. It is often recommended for patients with more significant symptoms of liver disease such as bleeding disorders or abdominal fluid. A catheter (small hollow tube) is inserted into the jugular vein in the neck, and guided into a vein in the liver with the assistance of x-ray imaging. A small needle is inserted into the tube and a sample of tissue is removed from the liver. This sample is then sent to a laboratory for analysis.
Transjugular intrahepatic portosystemic shunt or TIPS, is a procedure that is performed to relieve increased pressure in the portal venous system. This pressure buildup can result in gastrointestinal bleeding or the accumulation of fluid in the abdomen. This condition is often a result of chronic liver problems leading to cirrhosis (scarring of the liver).
During a TIPS procedure, an interventional radiologist uses imaging guidance to connect the portal vein to the hepatic vein in the liver. A small metal tube (called a stent) is placed to keep the connection open.
Chest ports are a type of central venous catheter. They are placed completely under your skin, just below your clavicle and connect to a vein in your chest. Chest ports reduce the number of times a nurse needs to insert a needle in your vein. They also allow for treatments that are longer than one day. Ports can remain in place for weeks, months or years.
Gastrostomy refers to the placement of a feeding tube through the skin and into the stomach. It is performed for feeding and nutritional support. In some cases a longer type of tube – a gastrojejunostomy – is placed so that the tip of the tube is in the intestine and nutritional feeding can bypass the stomach.
Nephrostomy refers to the placement of a tube from the back, through the skin and then into the kidney. It serves to drain any urine that is blocked and prevented from emptying into the bladder. This allows the kidney to function properly and protects it from further damage. It also helps clear any infection. In some cases a longer type of tube – a nephroureterostomy – is placed so that the tip of the tube is in the bladder.
Biliary drainage is the insertion of a tube into the bile duct. This is performed when the bile ducts are blocked. Blockage of the bile ducts can occur for a number of reasons, including gallstones, scarring of the bile ducts after prior surgery or even cancer in the liver. Biliary drains are placed through the skin into one of the bile ducts in the liver and then down into the small intestine. This allows bile to drain either externally into a bag or internally into the intestinal tract. In some cases, a metal tube (stent) can be placed so that no device protrudes outside the body.
Choleystostomy refers to the placement of a plastic drain into the gallbladder. This is performed when the gallbladder is infected or inflamed (cholecystitis). If left untreated, cholecystitis may lead to more serious infection or even gallbladder rupture, both of which can be life-threatening. Cholecystostomy can relieve symptoms until surgery can be safely done at a later time.
Uterine fibroid embolization (UFE) is a minimally invasive procedure for the treatment of uterine fibroids. The process typically lasts less than an hour and requires only a small nick in the skin. The procedure works by blocking the blood supply to the uterine fibroids, which causes them to shrink. UFE offers a shorter hospital stay, a faster return to work and fewer complications compared with traditional surgery
We spoke with experts Rakesh Navuluri, MD, and Osmanuddin Ahmed, MD, about benign prostatic hyperplasia (BPH) and the non-invasive treatment options available at UChicago Medicine.Watch Video Watch Video With Transcript