Interventional Radiology

Minimally Invasive/Non-Surgical Techniques

Most interventional radiology procedures are quick, same day, and very safe. They also allow for shorter recovery times with as good or better outcomes than more invasive, traditional surgical procedures. 

The sophisticated digital and computer-enhanced imaging equipment in our Interventional Radiology Suite allows physicians to perform high-tech procedures with unprecedented imaging using extremely low radiation. 
 

Interventional Back Pain Management

Image-guided procedures can help effectively treat various kinds of chronic back pain. Most procedures are short, allowing patients to return home the same day and often get back to normal activity the next day. Image-guided back pain procedures do not cure the cause of back pain, but they can provide much needed relief while a patient heals from injury or awaits surgery. Referrals are coordinated through a patient's primary care or pain management provider.

Epidural Steroid Injection (ESI)

Epidural steroid injection, or ESI, directs relief to the nerve or group of nerves in the epidural space of the spine. A physician directs the needle using an x-ray, while a combination of anesthetic and steroids are applied at the injection site. The procedure can be repeated several times a year, although a patient may experience different results each time.

The effectiveness of an ESI can last anywhere from a few weeks to a year. Injections alone may not provide total relief but can ease symptoms while patients heal on their own, participate in physical therapy, or await surgery.  

Rhizotomy

Rhizotomy ablates – or burns – the sensory nerves coming from the spine’s facet joints.  It is used to ease chronic pain in the neck or lower back, often stemming from arthritis. Treatments typically last for six to twelve months and can be repeated and can work alongside other forms of therapy. 

Prior to the procedure, a patient will need to have up to three nerve block injections to isolate the affected nerves. During the rhizotomy, a physician numbs the injection site and will insert an electrode needle through a catheter into the area of the inflamed nerve. The physician uses a real-time x-ray, to guide the needle to the correct location. Once the needle is in place, the tip heats up and burns the ends of the nerves, blocking their sensation and providing immediate pain relief. 

Kyphoplasty

Kyphoplasty is a procedure that treats compression fractures of the vertebrae, a condition often seen in patients with osteoporosis. 

A balloon inserted through a catheter into the damaged vertebra creates a cavity which is filled with a cement-like material that hardens. This restores the structure of the vertebra and provides immediate pain relief.

CMC has expanded its kyphoplasty program and now conducts procedures for both inpatients and outpatients. For outpatients, the procedure is performed same-day and does not require a hospital stay. 

We work in collaboration with the Pain Center at CMC to offer a comprehensive care plan incorporating a range of traditional and non-traditional therapies to treat pain. 

SPG Block 

The SPG block is a procedure that can provide relief from migraines and other headache and facial pain. In this image-guided procedure, an interventional radiologist delivers concentrated lidocaine, a pain reliever, through the nose and applies it directly to the group of nerves that causes these headaches. Relief is often immediate and lasts for weeks or months without the need for other injections or medicines.

SPG block is effective for the treatment of migraines, sinus and cluster headaches as well as spinal headaches, atypical facial pain, and some trigeminal neuralgia. It can also help other symptoms associated with severe headaches, like nausea, as well as severe vomiting during pregnancy and the symptoms of head and neck cancer.

The procedure takes about 20 minutes, is virtually pain free and has no required preparation. SPG is about 90 percent effective and can be repeated as needed to reduce pain.

Pelvic Congestion

Pelvic congestion is an often painful condition in which varicose veins occur in the pelvis. These enlarged, inflamed ovarian veins can compress organs around the pelvic region causing discomfort:

• Pain, pressure, or a throbbing sensation of fullness

• Pain that increases after long periods of standing

Pelvic congestion occurs in pre-menopausal women and is often misdiagnosed and/or misunderstood. Women with pelvic congestion may also have visible varicose veins on their legs. 

The condition can be detected with a pelvic ultrasound, MRI or CT scan and can be successfully treated through embolization. During this procedure, a radiologist will insert a catheter into the affected ovarian veins and place a coil that will block the blood supply and shut down the veins. 

This same day procedure is a highly-effective treatment for a widely undiagnosed and painful condition and is an alternative to hysterectomy. Embolization relieves the symptoms of pelvic congestion with no proven, long-term effect on fertility.

Uterine Fibroid Embolization (UFE)

Uterine fibroids are abnormal growths in the muscle of the uterus. They are fairly common and can cause a number of uncomfortable symptoms, including:

• Heavy periods

• Pain, pressure, or a feeling of fullness

• Need to urinate frequently

• Constipation

• Difficulty getting pregnant

Uterine fibroid embolization (UFE) is a minimally invasive treatment and an alternative to a myomectomy or hysterectomy. During this procedure, a radiologist will use image guidance to insert a catheter through the femoral artery into the uterus and direct small, plastic beads into the fibroid.  Those beads, called microspheres, block the blood supply to the fibroids, which then shrink to relieve the patient’s symptoms.

UFE avoids many of the possible complications of a hysterectomy and preserves a woman’s fertility. Women are often able to return home the same day and are able to return to work within 24 to 48 hours. 

Cardiology Imaging for TAVR

TAVR (Transcatheter Aortic Valve Replacement) is a minimally invasive procedure to replace the aortic valve in patients who have severe aortic stenosis, or narrowing of the valve opening. The TAVR device is a small, round mesh implant that is inserted via a catheter and pushes away the old valve, taking its place and eliminating the need for open heart surgery.

Prior to having a TAVR procedure, the patient will undergo an in-depth CT scan to gain a full picture of the heart, other organs, and the artery the catheter will travel through for the procedure. With a detailed, 3-D image of the heart the cardiologist can map the procedure and determine what size implant to use. The imaging also helps the doctors understand whether the patient has any potentially complicating conditions, like cancer or vascular disease. 

The radiologist also takes part in the TAVR procedure, guiding the cardiologist with CT and x-ray to feed the valve implant through the catheter and deploy it in the heart. Patients typically spend the night in the hospital and go home the next day. CMC’s TAVR program is one of the leading programs in the country.  We’ve performed hundreds of these procedures since 2015 and are often highlighted at industry conferences as an exemplary program. 

Long Term Venous Access

Some patients may require a catheter placed under the skin to make it easier to administer chemotherapy drugs, draw blood, or drain fluids. 

Radiologists can place a peripherally inserted central catheter (PICC) or port for long term vascular access, benefiting patients who need a prolonged course of medication therapy, other forms of IV infusion, or intravenous nutrition.

A drainage catheter may be needed for patients with fluid buildup around the lung or in the abdomen. This device can be a more comfortable alternative to repeat blood draws and fluid drainages.