Interventional Radiology
Interventional Radiology is a sub specialist branch of Radiology that diagnoses and treats conditions using tiny miniaturised tools while watching their progress on an x-ray monitor. Typically this is used to treat conditions such as arterial narrowing as well as blockages of the bile ducts and problems within the kidneys or ureters (the tubes that connect the kidneys to the bladder). Typically these procedures are performed under local anaesthetic, sometimes with a little sedation. The tubes (catheters) that are used are very small, typically 1-2mm in diameter. These techniques are much less invasive for the patient than open surgical procedures or even laparoscopy (key-hole surgery). Indeed many people call them “pin-hole” procedures!
Interventional Radiologists have an extensive subspecialist training in this field. This work is always carried out in very close conjunction with the referring physician or surgeon. The three Radiologists with principal interventional interest are Dr Ignotus, Dr Wetton and Dr Garrett.
Types of interventional radiology procedures include:
- Angiograms
- These are procedures where a tiny catheter is introduced into a blood vessel and a “road map” of the arteries or veins obtained to see whether any are blocked, narrowed or in any other way abnormal.
- Angioplasty
- In this technique, a small balloon is passed through the narrowing (or blockage) and inflated to open it up, thus allowing more blood to flow through an organ which is relatively deprived of blood. This is typically used in the legs if patients’ arteries are blocked and they are not receiving enough blood to allow them to walk a reasonable distance or if they have so little blood that they get pain at rest.
- Stents
- A similar procedure to angioplasty, except that a fine metal mesh or tube is left to act as a support to hold the artery open.
- Embolisation
- This technique is used to block abnormal arteries if too much blood is flowing to a particular organ. This is also commonly used to block a particular vein which can drain the testicle in men, particularly for those men who have a benign but sometimes uncomfortable condition called a varicocele.
- Fibroid embolisation
- Around 40% of women over the age of 40 will have fibroids of the uterus. Most of these cause no symptoms, but some women have symptoms related to the size of the fibroids (e.g., pressure on the bladder) or have abnormally heavy menstrual bleeding. Many patients with fibroids can have their symptoms easily treated by embolisation, a technique where the arteries supplying the womb are blocked. The procedure usually takes between 40 minutes and an hour and only involves an overnight stay in hospital. Unlike hysterectomy or other surgical procedures, the patient can drive again within a day or two and is often back at work within a week.
- Biopsy
- Biopsy techniques involve sampling of tissue. A fine needle (usually less than1mm in diameter) is passed under local anaesthetic into an abnormal organ so that a tiny fragment of tissue can be taken out for analysis under the microscope. These procedures are often performed as an outpatient. Otherwise the patient need only stay in hospital for 4-5 hours afterwards. This procedure allows accurate diagnosis of conditions and has made open surgical biopsies almost obsolete.
- Non Vascular procedures (Urological / Biliary tract)
- These mostly relate to draining and stenting (inserting tubes into) the bile ducts in obstructive jaundice or the kidneys if the ureters (tubes from the kidneys to the bladder) are blocked. This is a very specialised field in which two of our radiologists have a great deal of expertise. The procedures are usually performed under local anaesthetic and sometimes mild sedation. Please contact us if you require further details of these procedures
