Interventional Radiology

 

IR

Interventional Radiology (IR) is a field of medicine that uses minimally invasive techniques and imaging guidance to perform procedures that can replace conventional surgery.

MedStar St. Mary's team of interventional radiologists can treat diseases or conditions in almost any area of medicine. For example, IR specialists can break up clots inside arteries, block off blood vessels that feed tumors, treat varicose veins, deliver cancer treatment directly to a tumor through its own blood supply, drain blocked organs, and perform biopsies—all by way of tiny incisions, into which surgical instruments are navigated, under image guidance, to the target area.

Image guidance includes X-rays, magnetic resonance (MR) and computed tomography (CT) scans and ultrasound.

Common interventional imaging technologies include:

  • CT
  • Fluoroscopy
  • MRI
  • Ultrasound
  • X-ray

Several advantages to interventional radiology procedures exist, including:

  • Most IR procedures can be performed on an outpatient basis.
  • Patients undergoing an IR procedure typically do not require general anesthesia, so they retain the ability to breathe on their own, are conscious, and can respond to instructions.
  • Outcomes with interventional radiology procedures are equal to or better than outcomes for patients undergoing traditional surgery. IR techniques have proven so effective, they have been adapted to a variety of surgical procedures; in some cases, they have replaced traditional surgery as a treatment option.

Interventional procedures performed at MedStar Health include:

  • Ablation
  • Angioplasty
  • Computed tomography angiography (CTA)
  • Interventional oncology
  • Kyphoplasty and vertebroplasty
  • Obstructions
  • Percutaneous image-guided biopsy
  • Embolization
    • Chemoembolization
    • Radio frequency
    • Uterine artery
    • Uterine fibroid
    • Varicocele
  • Varicose vein treatment

Ablation

Ablation is the thermal destruction of tissue that treats

  • Primary liver cancer
  • Metastatic cancer to liver
  • Lung cancer
  • Kidney cancer

In this localized treatment, tumor tissue is killed with either heat or extreme cold. Patients are usually discharged home the same day or next day after the procedure and return to their baseline status days after the procedure.

Chemoembolization

In chemoembolization, a catheter is placed into the liver, and chemotherapy drugs are injected directly into the liver arteries. This technique delivers chemotherapy at much higher doses than traditional treatment and in a way that spares the rest of the body from chemotherapy side effects.

However, is not a curative treatment; it is designed to increase the patient’s life expectancy and improve cancer-related symptoms.

Chemoembolization treats liver cancers, including:

  • Primary liver cancer (Hepatocellular carcinoma)
  • Metastatic liver cancers:
    • Colon
    • Neuroendocrine
    • Cholangiocarcinoma
    • Breast
    • Pancreas
    • Kidney
    • Head and neck

Interventional Oncology

At MedStar Health, our subspecialty-certified interventional radiologists work with oncologists to diagnose and treat cancer. After biopsy, tumors often can be treated with minimally invasive techniques, including chemoembolization, radioembolization, and ablation.

Interventional oncology provides treatment for the following cancers using minimally invasive techniques:

  • Primary liver cancer (hepatocellular carcinoma)
  • Metastatic cancers with spread to liver including:
  • Colon cancer
  • Neuroendocrine tumor
  • Cholangiocarcinoma
  • Breast cancer
  • Pancreatic cancer
  • Head and neck cancer

Radioembolization

In radioembolization, small particles with attached Yttrium-90 radiation are injected into a catheter in the liver’s blood vessel. The radiation is thought to selectively target the tumoral tissue; however, this is not a curative treatment. Similar to chemotherapy, it is designed to increase the patient’s life expectancy and improve cancer-related symptoms.

Radioembolization treats cancers in the liver, including

  • Primary liver cancer (Hepatocellular carcinoma)
  • Metastatic liver cancer
  • Colon
  • Neuroendocrine
  • Cholangiocarcinoma
  • Breast
  • Pancreas
  • Kidney
  • Head and neck

Kyphoplasty and Vertebroplasty

Kyphoplasty and vertebroplasty are minimally invasive procedures used to relieve the pain from a vertebral fracture, especially if it does not improve over a number of weeks with pain medication and treatment with a brace. Certain diseases, such as osteoporosis or cancer, are known to cause loss of bone mass and changes in bone structure, making them brittle and weak. Genetic factors and certain lifestyles, such as a low calcium diet, can also damage bone. Over time, the vertebral bodies can become so weak that normal activities such as bending over or lifting a bag of groceries, can cause a spinal fracture.

Both vertebroplasty and kyphoplasty procedures involve placing cement into the fractured vertebra through small incisions in the skin under x-ray guidance.

Kyphoplasty can also be very helpful when there is severe collapse of the broken vertebra or wedging. By correcting the wedging, kyphoplasty may help restore the spine to a more normal alignment and prevent severe kyphotic (hunchback) deformity to the spine. In someone who has had multiple fractures with previous wedging, kyphoplasty can prevent further worsening of the deformity.

Vertebroplasty

  • Bone cement is injected under pressure directly into the fractured vertebra.
  • Once in position, the cement hardens in about 10 minutes, congealing the fragments of the fractured vertebra and providing immediate stability.

Kyphoplasty

  • A balloon catheter is guided into the vertebra and inflated with a liquid under pressure.
  • As the balloon inflates, it can restore the collapse in the vertebra and correct abnormal wedging of the broken vertebra.
  • Once the balloon is maximally inflated, it is deflated and removed, and the large cavity created is filled with bone cement.
  • The cement then hardens in place, maintaining any correction of collapse and wedging.