Interventional Radiology 101

Q & A about Interventional Radiology with Sean Zivin, M.D.

What is interventional radiology (IR)?

IR is a form of image-guided surgery using radiological imaging (X-ray, ultrasound, CT) to guide small-caliber equipment into parts of the body to precisely diagnose and directly target therapy. Many procedures start with passing a needle through the skin to the target and can be called ‘pinhole’ surgery.

Interventional radiologists are doctors who are trained in both diagnostic image interpretation and interventional therapy, utilizing a unique combination of skills in order to manipulate needles, fine catheter tubes and wires to navigate around the body under imaging control.

What can be treated with the use of interventional radiology?

IR can be used to diagnose and treat a wide array of diseases and clinical conditions throughout the body. This includes treatment of both vascular and non-vascular conditions. Examples of conditions treated include:

• Kidney stones
• Spine fractures
• Tumors (benign and malignant)
• Uterine fibroids
• Varicose veins

In addition, interventional radiologists often are called upon by other doctors for help with patients who present challenging or emergent conditions, such as acute bleeding, aneurysms or vascular clotting.

What do patients typically experience in a procedure?

A priority for IR procedures is the patient’s comfort and safety. The procedure encompasses not only the procedure but the pre- and post-operative care. When the patient is brought to the interventional suite, a nurse, technologist and the doctor work in conjunction to ensure the patient is informed and relaxed.

The degree of anesthesia varies with the type and length of the procedure, but most often encompasses local anesthesia and moderate conscious sedation with occasional use of general anesthesia.

Once positioned on the table, the sites of access are cleaned with an aseptic solution and the patient is relaxed and appropriately sedated. The procedure is then performed with high quality and effectiveness in mind. Procedures can range from a few minutes to a few hours, depending on the anatomy, diagnosis and technical factors involved.

The interventional radiologist uses every effort to use the lowest amount of X-ray radiation necessary. Contrast dye fluid may be injected into the access catheter in order to better visualize the organs or structures being studied, depending on the type of procedure.

What are the benefits of interventional radiology?

IR procedures can be performed minimally invasively and without large surgical incisions. The procedures can be performed safely and accurately with faster recovery time utilizing local anesthesia and lower degrees of sedation. There are decreased risks, lower morbidities and shorter recovery times utilizing these interventional techniques, ultimately leading to high patient satisfaction, low costs and high quality outcomes.

What are the risks of interventional radiology?

Similar to all surgical procedures, the risks may include bleeding or infection. However, this is considered to be a low risk. Other risks may include renal insufficiency (kidney failure) from the IV contrast dye -(low likelihood) or incomplete therapy, depending on the technical difficulty involved.

What is an average recovery time from a procedure?

The post-operative care required will depend on the type and extent of the procedure performed. A majority of the procedures will likely require a recovery period in the range of two to four hours. If there is pain or discomfort present, appropriate therapies are offered and administered in order to control symptoms.

A majority of interventional radiology procedures are well tolerated with minimal post-operative symptoms. Detailed instructions related to post-discharge care are tailored to the procedure performed. Depending on the level of procedure, some patients can expect to feel back to normal the next day, or may require a few days for full recovery.

Sean Zivin, M.D., is a board-certified diagnostic and interventional radiologist with Northwest Radiology Associates, S.C.

Read more about interventional radiology at Northwest Community Hospital or call 847-618-3700 to schedule an appointment.