For many years, surgery was the only treatment available for many conditions. Today, minimally invasive procedures using x-rays, ultrasound, and other imaging guidance are often alternatives to surgery for a wide variety of conditions. A physician known as an interventional radiologist often performs these procedures. Interventional radiologists are board-certified physicians who specialize in minimally invasive treatments using x-ray guidance, which often offers less risk, less pain and less recovery time compared to open surgery.
Examples of minimally invasive treatments that are performed under x-ray guidance include treatment for varicose veins, placement of central venous catheters for patients needing long-term access for medications, biopsies of the thyroid and liver, vertebroplasty, treatments for uterine fibroids, drainage of fluid from abdomen and lungs, and treatment of poorly functioning dialysis grafts or catheters in patients who are undergoing dialysis for kidney failure.
Varicose veins are an example of a medical condition that can be treated with excellent results by an experienced interventional radiologist. Varicose veins are most commonly due to venous reflux disease. Venous reflux is blood flow that goes “backwards” in the vein. Duplex ultrasound is used to identify the presence of venous reflux disease. The most common vein involved is the greater saphenous vein, in the thigh. Reflux within the greater saphenous vein leads to pooling in the visible varicose veins below. By closing the greater saphenous vein with a procedure known as endovenous vein ablation, the twisted and dilated branch veins, which are close to the skin, shrink and improve in appearance. Once the diseased vein is closed, other healthy veins take over to carry blood from the leg, re-establishing normal flow.
The vein ablation procedure is performed safely and comfortably in the outpatient setting under local anesthetic. Patients often notice improvement within a few days after the procedure. A recent study in the Journal of Vascular Surgery compared surgery to remove varicose veins to the less invasive ablation procedure by evaluating procedure-related complications, overall patient recuperation and quality-of-life issues. In every measurable category, patients who underwent the ablation procedure had better outcomes.
Vertebroplasty is another procedure performed by an interventional radiologist. In this procedure, a needle is inserted into a fractured vertebral body of the spine under x-ray guidance, and a special type of cement is injected through the needle. The cement hardens almost immediately, and provides very rapid relief of back pain due to a compression fracture of the spine. An interventional radiologist can determine if a patient is a candidate for this procedure.
There are a number of other medical conditions that can be successfully treated in the outpatient setting using minimally invasive techniques with x-ray guidance. Interventional radiologists are quickly becoming an integral part of patient care in conjunction with other specialists and primary care physicians. Avoiding a hospital stay, decreased risk of infection and shorter recovery time are just a few of the advantages of treatment on an outpatient basis. Along with your primary doctor, the interventional center can provide a plan of care that most patients find preferable to a traditional hospital setting.