Arterial Procedures

What are Arterial Procedures?

Arterial Procedures are interventional radiology techniques used to diagnose and treat arterial disease anywhere in the body. The latter occurs when blood vessels are narrowed or blocked by fatty deposits. Blood flow to these areas of the body decreases, thus harming surrounding tissues. 

What is Diagnostic Arteriography of all arteries?

Arteriography is an X-ray exam of the arteries to diagnose blockages and other blood vessel problems. An interventional radiologist performs this X-ray procedure. During the arteriogram the doctor inserts a thin tube or catheter into the artery through a small nick in the skin about the size of the tip of a pencil. A substance called a contrast agent (Xray dye) is injected to make the arteries visible on the X-ray.

One of the most common reasons for an arteriogram is to see if there is a blockage or narrowing in a blood vessel that may interfere with the normal flow of blood through the body. In many cases, the interventional radiologist can treat a blocked artery without surgery at the same time that the arteriogram is performed. Interventional radiologists treat blockages with techniques called angioplasty and thrombolysis.

Recannalization of vessels – any location

Recannalization of vessels in any location in the body is done using laser. A laser endoscope was devised using optic fibers in order to provide a means of visualization and removal of plaques from arteries. The plaques, which block the arteries, are lased off in a few seconds.

All about Angioplasty

In this technique the interventional radiologist inserts a very small balloon attached to a thin tube (catheter) into a blood vessel through a small nick in the skin. The catheter is threaded under X-ray guidance to the site of the blocked artery. The balloon is inflated to open the artery.

What are Vascular Stents?

Vascular stents are small metal scaffolds or tubes which are inserted into the blood vessel to hold it open. They can be inserted anywhere in the body.

Thrombolysis  of peripheral, visceral and cerebral vessels

Thrombolysis or thrombolytic treatment is used when the blockage in an artery is caused by a blood clot. Thrombolytic drugs that dissolve clots are injected through a catheter to eliminate the clot and restore the blood flow.

Embolization of vessels for bleeding

Interventional radiologists can treat hemorrhage anywhere in the body by embolization. Studies have shown that this minimally invasive interventional technique substantially reduced the risk of subsequent severe disability or death compared to surgical repair in those patients who were candidates for both procedures.

During embolization, an interventional radiologist inserts a catheter through a nick in the skin and advances it to the site of the ruptured blood vessel. An embolizing agent—a  substance that clots or closes off the bleeding blood vessel—is injected under X-ray guidance. Most commonly, tiny metal coils are used to embolize and block the abnormal blood vessel or aneurysm. The catheter is withdrawn and the coils remain to provide the occlusion. The same technique can be used to treat aneurysms before they rupture. Surgery had been the primary treatment available until the platinum coil device was approved by the FDA in 1995.

Chemoembolization of tumors (HCC, metastatic disease to liver)

Chemoembolization is a palliative treatment for liver cancer. This can be a cancer originating in the liver or a cancer that has spread ("metastasized") to the liver from other areas in the body. During chemoembolization, three chemotherapy drugs are injected directly into the artery that supplies blood to the tumor in the liver. The artery is then blocked off ("embolized") with a mixture of oil and tiny particles.

Preoperative embolization of tumors

Many of the tumors that occur in the head, neck, and spine have a large blood supply. This can make surgical removal of these tumors difficult and risky. These tumors include meningiomas (tumors of the covering of the brain), paragangliomas or glomus tumors (tumors associated with nerves of the head and neck), juvenile nasopharyngeal angiofibromas (tumors of the nose that occur in young males), head and neck cancers, and tumors of the bones of the spine (vertebrae). When surgery is planned, a catheter can be placed into an artery (usually in the leg, like for an angiogram of the heart) and a tiny catheter threaded up through this to the artery or arteries supplying the tumor. Material is injected to block off the blood supply to the tumor (this is called embolization). There are many different kinds of materials available for this, depending on the type of tumor, its location, and the size of the blood vessels. This is usually performed within a few days before surgery. Sometimes, especially in the case of tumors of the vertebrae (or other bones), a needle is inserted through the skin directly into the bone containing the tumor and material is injected to block the blood supply or kill the tumor.

Uterine Fibroids

What are Uterine Fibroids?

Uterine fibroids are the most common tumors of the female genital tract. You might hear them referred to as "fibroids" or by several other names, including leiomyoma, leiomyomata, myoma and fibromyoma. Fibroids are noncancerous (benign) growths that develop in the muscular wall of the uterus. While fibroids do not always cause symptoms, their size and location can lead to problems for some women, including pain and heavy bleeding.

What is Uterine Fibroid Embolization?

This is a non-surgical treatment that causes the fibroid to shrink. Known medically as uterine artery embolization, this approach to the treatment of fibroids blocks the arteries that supply blood to the fibroids causing them to shrink. It is a minimally-invasive procedure, which means it requires only a tiny nick in the skin, and is performed while the patient is conscious but sedated — drowsy and feeling no pain.

Fibroid embolization is performed by an interventional radiologist, a physician who is specially trained to perform this and other minimally-invasive procedures.

The interventional radiologist makes a small nick in the skin (less than one-quarter of an inch) in the groin to access the femoral artery, and inserts a tiny tube (catheter--like a piece of spaghetti) into the artery. Local anesthesia is used so the needle puncture is not painful. The catheter is guided through artery to the uterus while the interventional radiologist guides the process of the procedure using a moving X-ray (fluoroscopy).

The interventional radiologist injects tiny plastic particles the size of grains of sand into the artery that is supplying blood to the fibroid tumor. This cuts off the blood flow and causes the tumor (or tumors) to shrink. The artery on the other side of the uterus is then treated. The skin puncture where the catheter was inserted is cleaned and covered with a bandage.