Interventional radiology treatments

Atherectomy

Atherectomy is a procedure used to open up an artery by removing plaque. It can be done by inserting a catheter into an artery, like in balloon angioplasty. Special devices are then used to “drill out” the plaque. Atherectomy is done most often in major arteries, such as coronary arteries in the heart and carotid and vertebral arteries that lead to the head and brain. Atherectomy is sometimes called the “roto rooter” procedure.

Carotid stenting

Carotid arteries are in your neck and supply blood to your brain. Carotid stenting can be done when blockages develop in carotid arteries. First, the doctor inserts a catheter (a thin, flexible tube) with a tiny balloon on the end into an artery. It is threaded through the artery until it reaches the area of blockage, where it is inflated to open the artery. Then, a stent (a small metal tube) is placed within the artery to keep it open.

Dialysis access

Dialysis circulates blood through special filters to remove toxins when kidneys are unable to do so. Dialysis access is a connection between an artery and a vein that allows the blood flow necessary for hemodialysis. There are two ways for surgeons to make the connection.

• AV fistula. The vascular surgeon creates a direct connection between an artery and a vein in the wrist or upper arm just above the elbow. As a result, the vein grows larger and stronger, making repeated insertions for hemodialyis treatments easier.
• Graft. If you have small veins that won’t develop properly into a fistula, you can get a vascular access that uses a special tube to connect an artery and vein. Most grafts are made from strong and supple material that feels similar to a natural vein.

Each of these connections may encounter problems over time that can be treated by an interventional radiologist.

Embolization

Embolization is a treatment that closes blood vessels by blocking blood flow. It is used to treat abnormal bleeding, tumors, arteriovenous malformations (abnormal connections between arteries and veins) uterine artery fibroids and more. In this procedure, a catheter (a thin, flexible tube) is inserted into an artery, and a blocking agent (temporary or permanent) is injected through the catheter to lodge in the vessel. 

Endovascular stent graft

Endovascular stent grafts reinforce weak spots in blood vessels. They usually are used to treat abdominal aortic aneurysms or thoracic aortic aneurysms.  A stent graft is a metal and fabric tube that is placed inside the artery, where it seals tightly above and below the weak spot or aneurysm. This allows blood to flow through without pushing on the weak area. The graft is put in place using a catheter (a thin, flexible tube) that is threaded through the artery.

Radio frequency ablation, Cryoablation

Radio frequency ablation is a procedure that destroys (ablates) an abnormal cell or tumor.  During the procedure, a small needle is placed in the tumor through the skin. The tumor is heated (RF ablation) or cooled (cryoablation) until the tumor cells are dead. Patients go home the same day or may stay overnight. 

Thrombolysis

Thrombolysis is treatment to break up blood clots. Thrombolytic therapy is used to treat heart attacks and strokes. It involves the use of medications that dissolve blood clots. A catheter (a thin, flexible tube that is threaded into the vessel), is often used to deliver the medication directly to the clot.

TIPS

TIPS (transjugular intrahepatic portosystemic shunt) is a procedure used to treat portal hypertension. During this procedure, a connection is made between the portal vein and one of the veins connected to the liver. A stent (a small metal coil) is inserted to keep the connection open. This reroutes the blood flow in the liver and reduces pressure in the varices.

Vena cava filters

Vena cava filters are tiny nets that are inserted into veins to prevent blood clots from traveling to the lungs and causing pulmonary embolism. They usually are used when blood-thinning medications don’t work or cannot be used. New filters are available that can be removed at a later date.

Venous access

A venous access is a tube inserted into a vein so medications can be delivered directly into the bloodstream. This often is used for people who need repeated doses of medication or need to have blood drawn repeatedly. A venous access device can reduce or eliminate needle sticks and damage to blood vessels. These include ports, Hickman catheters, PICC lines and dialysis catheters.

Venous thrombectomy

Venous thrombectomy is a minimally invasive procedure to remove a blood clot in a vein. It is usually used to treat complications of deep vein thrombosis. The blood clot may be removed with a catheter or broken up with a tool attached to the tip of the catheter.