Interventional Radiology

 

Goodwin-Whit-Headshot-section chiefs
SECTION CHIEF
Dr. Whit Goodwin

MEDICAL DIRECTOR
IR NORTH LITTLE ROCK
Dr. Gary Allen

MEDICAL DIRECTOR
IR CLINIC LITTLE ROCK
Dr. Megan Chang

MEDICAL DIRECTOR
IR BAPTIST HEALTH CONWAY
Dr. Craig Steeds


 

Meet our Interventional Radiology Team


 

WHAT IS INTERVENTIONAL RADIOLOGY?

Interventional Radiology is one of the most rapidly expanding areas in medicine and has led the current movement toward minimally invasive therapy. It is a sub-specialty of radiology utilizing image-guided procedures to diagnose and treat diseases in nearly every organ system.

By using the least invasive techniques, we are able to provide:

* Minimal risk to the patient
* Improved health outcomes
* Less pain
* Less recovery time compared with open surgery
* Decreased length of hospital stay


WHAT DOES AN INTERVENTIONAL RADIOLOGIST DO?

Interventional Radiologists provide targeted treatments for many common disease processes utilizing a percutaneous (through the skin) approach, usually without an incision or suture. This is accomplished with an in-depth knowledge of the least invasive treatments available.

They use X-rays, CT, and MRI to advance a catheter in the body, usually in an artery or vein, to treat at the source of the disease, non-surgically. Interventional radiologists are true pioneers in minimally invasive modern medicine.

 


COMMONLY PERFORMED PROCEDURES:     PDF_file_icon_32x32

We are proud to announce that our own Gary Allen, M.D. was the first physician in central Arkansas to use Eluvia for treatment of Peripheral Artery Disease (PAD). Eluvia is a Drug-Eluting Vascular Stent System and the first peripheral vascular interventional technology approved in the U.S. to offer sustained release of antiproliferative drug to treat patients with PAD. This technology is currently not available at any other hospital in central Arkansas!

Angiogram

An angiogram is an imaging test that uses x-rays to view your body’s blood vessels. Our Interventional Radiologic Physicians often use this test to study narrow, blocked, enlarged, or malformed arteries or veins in many parts of your body, including your brain, heart, abdomen, and legs. When the arteries are studied, the test is also called an arteriogram. If the veins are studied, the test is called a venogram.

Angiogram: What to Expect

  • On the day of your procedure, you will sign in and complete any necessary paperwork
  • Evaluation performed by a Baptist Health nurse, as well as a specially trained Radiology Consultant nurse
  • A blood test to determine your blood’s ability to clot, as well as assess your kidney function may need to be performed
  • You will then be taken to the special Interventional Radiology suite that contains special X-ray equipment used by the Interventional Radiologist during your examination
  • You will be placed on a table where a Interventional Radiology Technologist will prepare you for your examination (cleaning and draping the skin)
  • One of our Interventional Radiologist will anesthetize the prepared skin area
  • A small needle is then inserted into your blood vessel through which a catheter is placed

In almost all cases, you are sedated during your examination. All of our patients report the worst part of the arteriogram is worrying about it beforehand… doing it is much easier!

NOTE
Do Not eat or drink anything after midnight on the day preceding your examination.


What to Expect After Angiogram

  • Catheter is removed from your artery or vein
  • An Interventional Radiology Technologist holds pressure on site of catheter until bleeding stops
  • You are taken to a recovery area for observation
  • In most cases, you can eat and drink after your examination
  • You are given instruction regarding what you may or may not do for the next 24 hours
  • You may receive a prescription from your Interventional Radiologist, which you should fill and take as directed

 

Angioplasty & Stent Placement

An angioplasty is a non-surgical procedure performed by Interventional Radiologists to open blocked or narrowed blood vessels caused by peripheral arterial disease (PAD) or other conditions.  Hospitalization and general anesthesia are usually not required. No stitches are necessary. Patients generally return to normal activity in a short amount of time.

Back and Nerve Pain Treatment

Our Interventional Radiology Department performs minimally invasive spine procedures to help patients manage back and neck pain, as well as help Orthopedic and Neurosurgeons diagnose and treat painful spinal conditions. All procedures are performed under image-guidance technology to maximize injection accuracy and patient safety.

Procedures to help manage back and neck pain include but are not limited to:

  • Epidural Steroid Injections
  • Nerve root blocks
  • Facet or Z-joint injections
  • Hip injections

Diagnostic Procedures offered include but are not limited to:

  • Myelograms
  • Disc aspirations

Deep Vein Thrombosis

Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in the leg. Deep vein thrombosis is a serious condition. Blood clots can break loose, travel through your bloodstream, and lodge in your lungs, blocking blood flow (pulmonary embolism).

Procedure

Catheter Directed Thrombolysis is a procedure designed to rapidly break up the clot, restore blood flow within the vein and potentially preserve valve function to minimize the risk of post-thrombotic syndrome.

  1. Using imaging guidance, a catheter is inserted and threaded into the vein that contains the clot
  2. The catheter tip is placed into the clot and a “clot-busting” drug is infused directly into the clot
  3. The catheter-directed technique produces a greater than 85% clinical resolution of pain, swelling and restoration of blood flow in the vein than without the procedure

Feeding Tube Placement & Maintenance

Image guided feeding tube placement is usually performed as an inpatient procedure by one of our Interventional Radiologist. The feeding tube is placed into the stomach lumen when patients are unable to maintain adequate caloric intake orally for a prolonged period of time. In addition to placing tubes for feeding, this procedure can also be performed when patients require gastric decompression (often at palliative point of care). The presence of a percutaneous feeding tube does not prevent the patient from eating.


What to Expect After Feeding Tube Placement

  • Mild pericatheter site pain may occur; if pain worsens, please consult your physician
  • Feeds usually begin within 24 hours of the procedure
  • Post-procedural reflux and vomiting are rare and may be improved upon by revision of the GI-tube
  • Residual nausea is usually treated with antiemetic medications

Inferior Vena Cava (IVC) Filter Placement and Removal

What They Are
An inferior vena cava (IVC) filter is a small filtering device placed in the inferior vena cava, a vein in the abdomen region of your body. The inferior vena cava vein’s main job is to return blood from the abdomen to the heart.Why We Place Them
One of our Interventional Radiologists uses image guidance to surgically implant the inferior vena cava (IVC) filter. The primary purpose of the IVC is to help prevent blood clots from traveling up into the lungs. If a blood clot located in the leg or pelvis veins travels to the lungs it could cause pulmonary embolism or blockage.  IVC filters help reduce the risk of pulmonary embolism by trapping large clots preventing them from reaching the heart and lungs. An IVC filter may be beneficial to patients who have a history of or are at risk of developing blood clots in the legs. These include those:

  • diagnosed with deep vein thrombosis (DVT).
  • with pulmonary embolus
  • who are trauma victims
  • who are immobile
  • cancer treatment
  • inherited blood disorders that cause clotting
  • obseity
  • who have recently had surgery or delivered a baby

Why Are They Sometimes Removed?

Often it is found the IVC filter is no longer needed.  This occurs when the risk of clot(s) travelling to the lung is no longer present.

Please Note:

  • Your referring physician will determine if blood thinners are still necessary
  • Placement or removal of an IVC filter does not address the cause of the deep vein thrombosis

How Should I Prepare?

Your doctor will instruct you on how to prepare and advise you on any changes to your regular medication schedule. You will also be advised on whether you should refrain from eating or drinking before your procedure.

  • Tell your doctor if there’s a possibility you are pregnant
  • Discuss any recent illnesses, medical conditions, allergies or problems with sedation
  • If you smoke, you may be asked to stop before your surgery. Smoking can delay healing. Talk with your provider if you need help to stop smoking.
  • Don’t eat or drink after midnight the night before your surgery.
  • Discuss all medications you’re taking including over-the-counter medicines, such as includes herbs, vitamins, and other supplements
  • You will be asked to sign a Consent Form and complete various paperwork including Patient History. Read the form carefully and ask questions if anything is not clear.
  • Leave jewelry at home
  • Wear loose, comfortable clothing
  • You may be asked to wear a gown
  • Please make arrangements to have someone drive you home after the procedure
  • Follow any other instructions from your provider.

Infertility

  • Fallopian Tube Recanalization
  • Male Varicocele Embolization

Fallopian Tube Recanalization

Fallopian tube recanalization (FTR) is a nonsurgical procedure, which does not require any needles or incisions. It is used to clear blockages in the fallopian tubes, a part of a woman’s reproductive system.

Procedure

  • A speculum is placed into the vagina and a catheter is passed through the cervix into the uterus
  • A liquid contrast agent is injected through the catheter
  • The uterine cavity is examined on a nearby monitor using an X-ray camera
  • A Hysterosalpingogram or HSG is taken (uterus and fallopian tube picture)
  • Our Interventional Radiologists determines if there is a blockage
  • If a blockage is discovered, the Interventional Radiologist will determine whether it is located on one or both fallopian tubes
  • A smaller catheter is threaded through the first catheter and into the fallopian tube to clear the blockage

Male Varicocele Embolization

A varicocele is a network of dilated blood vessels, or varicose veins, in the scrotum that may cause pain and lead to testicular atrophy (shrinkage of the testicles).

Embolization is a minimally invasive procedure performed by one of our Interventional Radiologist usually requiring no stitches or general anesthesia and only a 1/4 of an inch incision.

Procedure

  • Usually performed as an outpatient basis under sedation and local anesthesia
  • A small catheter is inserted into a vein through a small skin incision
  • A tube is placed into the varicocele vein under X-ray guidance
  • Small amounts of X-ray dye (contrast) are injected to confirm position of catheter
  • Tiny coils made of stainless steel or platinum, balloons, or other materials are inserted in vein. This blocks backflow or pressure in the varicocele (blood can still exit the testicle through other normal pathways)
  • Once no flow in the affected vein is confirmed, catheter is removed

Liver Disease; Cirrhosis & Portal Hypertension Management

Portal hypertension: An increase in blood pressure within the portal venous system of veins.

  • Vessels in liver are blocked
  • Blood cannot flow properly through the liver
  • High pressure in the portal system develops
  • Increased pressure in the portal vein leads to development of large, swollen veins (varices) within the esophagus, stomach, rectum, or umbilical area.

Common Causes of Portal Hypertension

  1. Cirrhosis of the liver; scarring which accompanies healing of liver injury. Scar tissue blocks the flow of blood through the liver.
  2. Blood clots in the portal vein; blockages of veins that carry blood from liver to the heart
  3. Schistosomiasis or Parasitic infection
  4. Sometimes the cause is unknown

Treatment

  1. Portal hypertension is treated without surgery, using a procedure called Transjugular Intrahepatic Portosystemic Shunt (TIPS).
  2. A catheter is threaded through a small incision in the skin near the neck
  3. Under X-ray guidance, a tunnel is created in the liver through which portal blood can flow back to the heart, effectively bypassing the diseased liver.
  4. Tunnel is held open by insertion of a small metal cylinder, called a stent

Interventional Oncology; Cancer Care

Image Guided Biopsy

  • A non-surgical procedure that helps differentiate between malignancy and other benign processes
  • Performed under image-guidance with X-ray, ultrasound, mammography, CT or MRI
  • During biopsy, a small amount of tissue is removed from the abnormal area with a needle for examination
  • Typically performed on an outpatient basis using local anesthesia

Ablation: A Local Thermal Treatment of Small Cancers

  • Imaging guidance is used to place a needle electrode through the skin into an affected area
  • High frequency electrical currents, microwaves, or rapid freezing probes are used to create heat or ice that destroys the cancer cells
  • Considered an effective treatment option for patients who might have difficulty with surgery or those whose tumors are less than one and a half inches in diameter

Transarterial Embolization – Stopping Tumor Growth by Blocking Tumor Blood Supply

  • Small incision is made in inner thigh
  • A catheter is inserted and guided into an artery near the tumor or abnormal tissue
  • Once in place, small particles made of tiny gelatin sponges or beads are injected blocking the artery and stopping flow of blood to the tumor or abnormal area of tissue

Kyphoplasty & Vertebroplasty

Kyphoplasty and Vertebroplasty and are minimally invasive procedures used to treat vertebral compression fractures (VCF) of the spine. These painful, wedge-shaped fractures can be caused by osteoporosis and injury. Left untreated, they can lead to a humped spine (kyphosis).  For more information please visit Radiologyinfo.com.

Pelvic Congestion Syndrome & Ovarian Vein Embolization


Pulmonary Embolism Treatment

Pulmonary embolism occurs when one or more arteries in the lungs become blocked from blood clots that have broken free, circulated and become trapped in the lungs. This blocks the oxygen supply, causes heart failure and can result in death. Pulmonary Embolism treatment uses targeted image-guided drug delivery with specially designed catheters to dissolve dangerous blood clots in the lungs.

Procedure

  1. One of our Interventional Radiologist will insert a specially designed catheter through a tiny incision into a blood vessel
  2. The catheter will then be guided using real-time imaging
  3. A clot busting medicine is slowly delivered directly into the clot over a 12 hour period, while you are monitored in the ICU for evidence of any treatment complication
  4. The catheter may also be used to mechanically break up clots and suction them away

Renal Disease (End Stage Renal Disease

Dialysis Catheter Placement

End stage renal disease (ESRD) patients require regular hemodialysis to perform kidney functions associated with removing toxic waste from the body. Hemodialysis can be accomplished by using a large caliber catheter placed into a major vein in the neck. This is performed by an Interventional Radiologist using image guidance

Arteriovenous Fistula Maintenance (AVF)

An arteriovenous fistula is created by surgically joining a vein and an artery in the forearm. This allows blood to flow from the artery into the vein, which is required to perform dialysis.

Our Interventional Radiologist can perform routine maintenance of your fistula to insure optimal function during dialysis sessions. This often requires opening a narrowed blood vessel in the fistula using a balloon or stent. In the event that a fistula becomes clotted, our Interventional Radiologist are often able to completely remove the clot from the fistula.

Uterine Fibroid Embolization (UFE): Fibroids of the Uterus


The most common type of non-cancerous growths in women, fibroids of the uterus, affects 7 out of 10 women. Our Interventional Department offers a non-surgical treatment option, Uterine fibroid embolization (UFE), to shrink and eliminate fibroids by interrupting their blood supply with the goal of preserving the uterus and possibly future fertility (there is no guarantee of maintaining fertility with this procedure).
In accordance to our department’s UFE Protocol, all patients require an Interventional Radiology consultation prior to the procedure. A detailed history, physical and review of the patient’s medical record will be performed. The UFE procedure and other potential treatment options will be discussed in detail with the patient.

Vascular Malformation Treatment

Vascular MalformationVenous malformations comprise either superficial or deep veins that are abnormally formed and dilated. They are congenital vascular anomalies of only veins, only lymph vessels, both veins and lymph vessels, or both arteries and veins.

  1. A nonsurgical method of closing down the blood or lymph flow into the malformation is performed by one of our Interventional Radiologists.
  2. A tiny plastic tubing is advanced into the feeding artery to the malformation.
  3. This is done without incisions or stitches and with only mild sedation.
  4. Medical glue, alcohol or small coils are then floated into the malformation until it is full and no longer has blood flowing through it.

Venous Access: Central Venous Catheter Placement

Radiology_Consultants_Venous Access- Central Venous Catheter Placement

This is a common procedure in interventional radiology and uses the aid of image guidance to quickly and safely insert a variety of venous access devices in a variety of patients. A central venous catheter, also called a central line, is a long, thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time, usually several weeks or more. A catheter is often inserted in the arm or chest through the skin into a large vein. The catheter is threaded through this vein until it reaches a large vein near the heart.

What is a central venous catheter used for?

  • Give long-term medicine treatment for pain, infection, cancer, or to supply nutrition. A central venous catheter can be left in place far longer than an intravenous needle (IV), which gives medicines into a vein near the skin surface
  • Give medicines that affect the heart, especially if a quick response to the medicine is required
  • Give large amounts of blood or fluid quickly
  • Take frequent blood samples without having to “stick” someone with a needle
  • Receive kidney dialysis if you have kidney failure

Vertebral Augmentation; Alleviation of Painful Spinal Fractures

Kyphoplasty and Vertebroplasty are minimally invasive, nonsurgical methods that stabilizes a fractured vertebrae using bone cement.

Procedure

  1. CT or X-ray is used to guide a needle into the fractured vertebrae
  2. A special bone cement is then injected
  3. The bone cement hardens immediately
  4. Most patients report significant pain relief
  5. Procedure usually takes less than 2 hours
  6. Most patients go home the same day

 


WHAT TO EXPECT FOLLOWING MY PROCEDURE?

IR_procedure_website

 

Your recovery is important to us. Following your procedure, our committed nursing team will closely monitor you in the immediate post procedural period.

Follow up in our dedicated Interventional Radiology Clinic will be arranged to ensure you are recovering appropriately and that no complications have arisen. Additional imaging may or may not be ordered to further monitor your disease process.

Together with your referring physician, we work to offer you the best available care. We are in continuous communication with your doctor.

 


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Important…

Please notify the Radiologic Physician and/or Technologist if there is a possibility you are pregnant.
Radiation is potentially harmful to a developing baby during pregnancy.

** All images are for educational purposes only. Consult your physician for a proper diagnosis.**

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