What is
Interventional Radiology?
by: Scott Abeles, R.N., B.S.N.
nterventional radiology is an advanced, specialized branch of radiology or medical imaging. Radiologists are physicians who specialize in interpreting medical imaging technology such as MRI, CT scan, X- ray, and ultra sound. Radiologists can make diagnoses based on medical imaging results. Interventional radiology is a relatively new (1970’s) and rapidly expanding aspect of radiology. Many medical specialties such as cardiology, neurology and vascular surgery, now have specialists who perform interventional procedures. Interventional radiology employs less invasive techniques to perform procedures under radiographic guidance to treat certain conditions and disorders. Some interventional procedures have replaced traditional surgical procedures, if applicable. Interventional radiology procedures are less invasive than surgery, which translates to less risk of infection, less pain, shorter hospital stay and others. A large number of interventional procedures can be done on an outpatient basis. Not every patient is an appropriate candidate for a less invasive procedure so check with your health care provider.
The most common interventional procedure is angioplasty. Performed by an interventional cardiologist, this procedure is done to view the coronary arteries to determine the extent of a patient’s disease, if any. Once access is gained to the patient’s vessels, specialized catheters are advanced to the heart. Once in the heart, under real-time imaging, the interventional cardiologist injects dye that can be seen under imaging through the coronary arteries. If a significant blockage or narrowing is seen, after balloon angioplasty is done, a stent can be deployed to keep the blockage open. Under certain circumstances, specialized catheters may need to be used to remove fresh clots from within the vessel.
Structural changes to the vessels outside of the heart and brain characterize peripheral vascular disease. Vessels involved are those that carry blood to the arms, legs, stomach or kidneys. Interventional radiology procedures can be used to treat peripheral vascular disorders. Placing stents in the vessel or removing a clot (mechanical or thrombolytic) can restore blood flow to the affected area. When appropriate, these less invasive procedures are replacing the need for more conventional, invasive surgical options such as bypass. The vascular system also involves the flow of blood back to the heart via the veins. Clots (DVT) can develop in veins that restrict the flow of blood back to the heart. If left untreated, these clots have the potential to cause significant illness or death. Interventional radiologists can treat these clots less invasively with either balloon angioplasty and stenting, or catheter-directed thromolysis. Catheter-directed thrombolysis is when clot- dissolving drugs are injected directly to the site of the clot.
Aneurysms are a structural disturbance in the lining of a blood vessel that causes the wall of the vessel, most commonly arteries, to balloon out and weaken. Depending on the size, this can be a medical emergency. Aneurysms vary in location, type and size. Depending on the size, type or location, a stent-graft can be placed within the aneurysm itself to reinforce the integrity of the vessel. An interventional radiologist and a vascular surgeon with special training in this procedure, place the stent graft into place under direct imaging of the aneurysm. Not all aneurysms can be fixed using this procedure, consult your physician to see if you are a candidate for this procedure. This procedure is a good option for patients who are to sick for an open surgical repair. Possibly the most exciting specialty of interventional radiology is interventional neuroradiology. An interventional neuroradiologist treats many neuro-vascular disorders that virtually had no treatment available. Treatments performed include angiograms, carotid artery stenting, aneurysm repair, and the treatment of an acute stroke with cerebral artery stenting. Significant progress has been made in the capacity to use coils for endovascular treatment of intracranial aneurysms in situations that might have appeared inappropriate a few years ago.
Interventional radiologists treat certain forms of cancer using cryotherapy. During cryotherapy, an interventional radiologist inserts special probes (under imaging) through the skin to the tumor. Once the probe is at its location, liquid nitrogen or argon gas is circulated through the cryoprobe.
Interventional radiology is a very exciting and rapidly emerging field of medicine. Interventional radiology, if applicable, has many advantages over conventional surgery, and because of these advantages it is gaining support from medical professionals.
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