Interventional Radiology

Interventional Radiology Services

Angiography

Angiography is a test that is used to examine blood vessels in key areas of the body and helps physicians diagnose and treat medical conditions. In catheter angiography, a thin plastic tube, called a catheter, is inserted into an artery through a small incision in the skin. The catheter is then guided through the arteries to the area to be examined.

Angioplasty & Stenting

This procedure is performed to improve blood flow in the body's arteries and veins. Imaging techniques are used to guide a balloon-tipped catheter (a long, thin tube) into an artery or vein and advance it to where the vessel is narrow or blocked. The balloon is then inflated to open the vessel, deflated and removed. During angioplasty, a stent (a small wire mesh tube) may be placed in the newly opened artery or vein to help it remain open.

Aortic Stent Graft

An endovascular stent graft is a tube composed of fabric supported by a metal mesh called a stent. It can be used for a variety of conditions involving the blood vessels, but most commonly is used to reinforce a weak spot in an artery called an aneurysm. The minimally invasive physicians of St. Paul Radiology typically use endovascular stent grafting to treat abdominal aortic aneurysms. These procedures require only a small incision or puncture in an artery or vein. Generally, endovascular treatments allow you to leave the hospital sooner and recover more quickly, with less pain and a lower risk of complications, and sometimes a lower risk of death, than traditional surgery because the incisions are smaller.

Needle Biopsy

During a needle biopsy, a special needle is used to extract cells from a suspicious area. When combined with an imaging procedure, such as x-ray, needle biopsy can be used to collect cells from a suspicious area that cannot be felt through the skin.

Bone Biopsy

A bone biopsy is a procedure in which a small sample of bone is taken from the body and looked at under a microscope for cancer, infection, or other bone disorders. A bone biopsy is often done on bone areas that show problems on an X-ray. A Computed Tomography (CT scan) may be used to guide the biopsy needle.

Dialysis Catheter Placement

For a patient whose kidneys have failed, access to the blood system must be established and maintained for dialysis treatments. Access can be provided by the placement of a dialysis catheter (a hollow, soft tube that has two openings – one to send your blood to the dialysis machine and the other to return the cleansed blood back to your body).

Fallopian Tube Recanalization

Interventional radiologists can diagnose and treat a blockage in the fallopian tubes with a procedure that does not require an incision. A flexible tube, or catheter, is placed into the uterus to open the blockage.

Nephrostomy

The interventional radiologist will use x-rays and/or ultrasound to locate your kidney and a needle will be inserted through your skin into the kidneys. The nephrostomy catheter is a small flexible, rubber tube that is placed through your skin into the kidney to drain your urine.

Ureteral Stents

A ureteral stent is placed in the ureter to restore the flow of urine to the bladder (which may become obstructed as a result of kidney stones, tumors, blood clots, post-surgical swelling, or infection). The stent may remain in place on a short-term (days to weeks) or long-term (weeks to months) basis.

Uterine Fibroid Embolization

Uterine fibroids are noncancerous tumors that grow in the uterus. They are not usually dangerous, but their symptoms can be painful and disruptive. There are many treatment options for uterine fibroids, but only interventional radiologists can perform UFE’s. Through a tiny incision in the wrist or groin, a catheter is inserted that delivers particles to block the small blood vessels feeding each uterine fibroid, causing them to shrink and disappear.

Kidney Stone Removal (performed with a Urologist)

A procedure called a Percutaneous Nephrolithotomy (PNL) is used to break up and remove kidney stones, and is performed by a urologist and radiologist. The radiologist provides access to the kidneys by inserting a catheter (a long, thin tube) and guides it to the desired location.

Transjugular Intrahepatic Portosystemic Shunts (TIPS)

This shunt is a small, tubular metal device, or stent, that is placed in veins in the middle of the liver to permit blood flow to bypass the liver and relieve increased pressure on the portal vein.

Biliary Drain Stenting

If there is a blockage and bile cannot drain from the liver into the gallbladder and intestines, it can be relieved or bypassed with a catheter (a long, thin tube) passed through the skin of the abdomen directly into the liver or gallbladder by a radiologist. The catheter is advanced across the site of blockage and allows the bile to drain past the obstruction both internally into the intestines, and externally to a bag connected to the catheter outside the body.

Biliary Stone Removal

A thin needle is inserted through the skin below the ribs and into the liver using x-ray guidance. A contrast material is injected into the liver and bile ducts and x-rays are taken. If imaging reveals a gallstone in the common bile duct (CBD), the doctor may make a small incision in the bile duct and remove the stone(s).

Arterial Thrombolysis

If you can't take medicines to thin your blood, a filter may be inserted into your arterial blood system. This filter prevents clots that break loose from lodging in your lungs, causing a pulmonary embolism. Occasionally, the use of mechanical devices to break up and to remove clot or clot-busting medicines (dissolve clot) are used to treat clots in arteries.

Chemoembolization

This minimally invasive procedure is performed by a specially trained interventional radiologist as a cancer treatment (most often liver cancer). Using x-ray guidance, a thin catheter is inserted through the skin and into the femoral artery (a large groin vessel) and advanced into the liver. Once the catheter is positioned in the branches of the artery that are feeding the tumor, the anti-cancer drugs and embolic agents are mixed together and injected.

Testicular Varicocele Embolization

This is an outpatient procedure to treat a varicocele (a tangled network of blood vessels) that affects blood flow to the testicles. In this type of treatment, a small tube is inserted into the groin through a small nick in the skin. A small catheter, or tube, is painlessly guided up into the abdomen and into the varicocele vein under the guidance of x-ray imaging.

Pelvic Varicocele Embolization

For females, the pelvic varicocele embolization procedure is a minimally invasive procedure performed by an interventional radiologist on an outpatient basis, with mild sedation. Using image guidance, the interventional radiologist places a catheter into the abnormal veins and permanently closes them, allowing blood to flow via ancillary healthy venous channels.

Questions About Interventional Radiology

Question: What is an interventional radiologist?

Answer: Interventional radiologists are board-certified physicians who specialize in minimally invasive, targeted treatments. They offer the most in-depth knowledge of the least invasive treatments available coupled with diagnostic and clinical experience across all specialties. They use X-rays, MRI and other imaging to advance a catheter in the body, usually in an artery, to treat at the source of the disease non-surgically. As the inventors of angioplasty and the catheter-delivered stent, which were first used in the legs to treat peripheral arterial disease, interventional radiologists pioneered minimally invasive modern medicine. Today many conditions that once required surgery can be treated nonsurgically by interventional radiologists. Interventional radiology treatments offer less risk, less pain and less recovery time compared to open surgery.

Question: How do I schedule a consult with an interventional radiologist to discuss procedure alternatives and review images?

Answer: To schedule a consult, please call our clinic at 651.917.9930. We would be happy to assist you.

Question: Should I be tested for Peripheral Arterial Disease?

Answer: Get tested for Peripheral Arterial Disease if you:

• Are over age 50
• Have a family history of vascular disease, such as PAD, aneurysm, heart attack or stroke
• Have high cholesterol and/or high lipid blood test
• Have diabetes
• Have ever smoked or smoke now
• Have an inactive lifestyle
• Have a personal history of high blood pressure, heart disease, or other vascular disease
• Have trouble walking that involves cramping or tiredness in the muscle with walking or exercising, which is relieved by resting
• Have pain in the legs or feet that awaken you at night

Question: Where do these procedures occur?

Answer: Our interventional radiologists perform procedures at the following hospitals: St Joseph's, St John's, Woodwinds, United and Regions.

Question: Who will give me my pre procedural instructions?

Answer: A Registered Nurse will call you the night before your procedure to go over your prep and answer any questions you may have regarding your procedure. If we see special circumstances surrounding your particular case, you may expect a call from one of our nurses at the time of scheduling to ensure that you are properly prepared for your procedure.

Question: What type of follow up care can I expect after my procedure?

Answer: Your follow up post procedure will depend upon the procedure. Most often you can expect to be seen in our clinic one month post procedure. The need for additional follow up appointments will be determined at that visit.

Question: Will I have to spend the night in the hospital?

Answer: Most of our procedures are done on an outpatient basis, however there are some procedures that do require an overnight stay. If your procedure requires an overnight stay, we will inform you of this at the time of scheduling.

Question: What if I have a question or a concern before or after my procedure?

Answer: Call our Interventional Clinic at 651.917.9930. Our clinic is open weekdays from 7:00AM to 5:00PM with nurses on site to take your calls. We have physicians available 24/7 to handle after hour and emergency calls.

Question: Do you have information that can be mailed to me about a specific procedure?

Answer: Yes we do have brochures available for most of our procedures. Please request information through our website. We would be glad to send you information.

Interventional Radiology Providers at St. Paul Radiology

• Amanjit S. Baadh, MD
• Andrew S. Bunney, MD
• Timothy C. Goertzen, MD
• Andrew S. Hartigan, MD
• Jorge A. Leon, MD
• Matthew J. Loe, MD
• Kevin Q. Nguyen, MD
• Cory R. Nordman, MD

Scheduling Your Interventional Radiology Procedure

Patients do need a referral from their specialist, surgeon or primary care physician for any interventional procedure. A St. Paul Radiology nurse will call you to make arrangements with you for your procedure, answer all questions, and notify you of preparation instructions. Remember, if you have imaging studies that were not done at St. Paul Radiology we ask that you arrange to have the CD's of each study sent to the IR clinic 2-3 days in advance of your scheduled procedure.

Call 651.917.9930 for the minimally invasive experts at St. Paul Radiology.