Spectrum’s team of vascular and interventional radiology specialists is highly skilled and experienced in performing these minimally invasive procedures:
Embolization
Embolization is a technique to prevent blood flow to a tumor (which needs blood to survive), or a faulty or enlarged vein. Coils or substances called embolic agents are delivered to the site endovascularly (via catheter from inside a vein or artery) with imaging guidance from fluoroscopy, x-rays that produce real-time moving images.
- Uterine artery embolization (UAE): This is used to treat fibroid tumors that can cause heavy menstrual bleeding, pain and pressure. Embolic agents block the arteries providing blood to the fibroids, causing them to shrink. Research shows that nearly 90% of women see significant or complete resolution of their fibroid-related symptoms after UAE.
- Embolization for pelvic congestion syndrome: Pelvic congestion syndrome is a painful condition that results from enlarged or varicose veins in the pelvis. Embolization helps relieve pain by delivering an embolic agent to close off the faulty veins so they can no longer enlarge with blood.
- Varicocele embolization: A varicocele is an enlarged vein in the scrotum, and it can cause pain, infertility and swelling. With embolization, blood is diverted away from the enlarged vein by placing a coil or embolic agents to block the vein.
- Prostate artery embolization (PAE): Prostate enlargement, known as benign prostatic hyperplasia (BPH), is a common condition in older men; it causes poor urinary flow, frequent urination, incomplete bladder emptying, and a sudden urge to urinate. When medications don’t relieve symptoms, PAE is an alternative to surgery. Small particles are injected into the prostate arteries to decrease blood supply to the prostate, reducing its size and symptoms.
Minimally invasive cancer treatment
Spectrum’s interventional radiologists offer a range of minimally invasive procedures to diagnose and treat cancer and help manage its symptoms. These include:
- Imaging-guided biopsies: An imaging-guided biopsy uses technology such as x-ray, ultrasound or a CT scan to guide the collection of cells or tissue for examination under a microscope. The collection process may involve a fine needle, a core needle, or a vacuum-assisted biopsy device. This procedure is a way of obtaining a biopsy sample from a suspicious area without surgery.
- Radiofrequency (RF) ablation: RF ablation uses electrical energy and heat to destroy cancer cells. Under imaging guidance, the interventional radiologist will insert a needle through the skin into a tumor. RF energy passes through the needle, heating up and killing nearby cells. RF ablation is most often used to treat small kidney, liver, lung tumors causing pain or other discomfort, particularly when surgery isn’t an option; it’s generally not used as the primary treatment for most cancers.
- Chemoembolization: In patients with primary or metastatic liver tumors, chemoembolization is an alternative for those who can’t undergo surgery. Under x-ray guidance, high-dose chemotherapy loaded onto tiny particles is delivered via catheter into the tumors. The particles slow blood supply to the tumor, starving it, and the high-dose chemotherapy allows for greater tumor kill. Plus, chemotherapy is delivered directly into the tumor, so there are fewer side effects than with systemic treatment.
- Cryotherapy: Cryotherapy kills cancer cells by freezing them. Spectrum’s VIR specialists use this technique to treat kidney cancer as well as cancers that have spread to the bone. Under imaging guidance, a special needle is inserted through the skin into the affected area, delivering argon gas to chill cancer cells to below -75º Celsius. This kills the cancer cells and a small margin of surrounding tissue. Studies indicate cryotherapy is as effective as traditional surgery for treating small kidney tumors.
- Y90 Treatment: Radioembolization (Y90) procedure is mostly used to treat liver cancers. It uses two procedures called embolization and radiation therapy. Radiation therapy consists of using ionizing radiation to kill or shrink the tumors. Embolization is used to block blood flow in which blood vessels or vascular malformations are blocked off.
Procedures to treat vascular problems
Spectrum’s interventional radiology specialists have extensive vascular expertise, enabling them to treat a range of vascular problems without surgery:
- Catheter-directed thrombolysis (CDT) for deep vein thrombosis (DVT): DVT occurs when a blood clot (thrombus) forms in one or more of the deep veins in the body, usually in the legs. With CDT, a clot-busting drug is delivered directly to the clot via catheter, using imaging guidance. The catheter then breaks up the clot with pressurized fluid and siphons it away.
- Balloon angioplasty and stenting for peripheral vascular disease (PVD): Peripheral vascular disease (also called peripheral arterial disease, or PAD) is a common circulatory problem in which narrowed arteries reduce blood flow to the extremities—usually the legs—often causing leg pain when walking (claudication). Angioplasty can open blocked arteries in the legs by expanding the inner diameter with a balloon mounted on a thin catheter. A stent may also be placed to help prop the artery open.
- Varicose vein treatments: Varicose veinsare enlarged and twisting veins, often appearing blue or dark purple, and can be painful as well as unsightly. They occur when faulty valves in the veins allow blood to flow in the wrong direction or to pool. Spectrum’s VIR specialists offer several treatments designed to address specific types of varicose veins:
- Sclerotherapy: A tiny needle is placed into small spider veins. An irritating solution called a sclerosant is injected, irritating the veins and causing them to swell. This cuts off blood flow, causing the vein to shrink.
- Microphlebectomy: This outpatient procedure uses small hooks to remove large varicose veins close to the skin surface. It’s performed under local anesthetic, requires no stitches, and is effective and long-lasting.
- Ultrasound-guided schlerotherapy: This method is used to treat deeper veins not seen or felt at the skin surface. Using ultrasound guidance, a tiny needle is placed into the deeper problem veins and a liquid sclerosant injected, causing them to swell then shrink.
- Endovenous laser therapy (EVLT): After applying a local anesthetic, the VIR specialist uses ultrasound guidance to place a thin catheter into the varicose vein(s). Laser energy then heats the vein from the inside and seals it closed. Blood flow is diverted to other healthy veins, and the surface varicose veins disappear.
Interventional procedures to treat spine compression fractures
A compression fracture is a bone fracture that occurs due to compression of the spine. Most compression fractures occur in vertebrae that have been weakened by osteoporosis or cancer, and they are extremely painful.
Spectrum’s interventional radiologists offer several procedures to treat the pain:
- Vertebroplasty: Under mild IV sedation, using local anesthesia, a needle is advanced into the fractured vertebral body under fluoroscopic guidance. A small amount of X-ray dye may be injected to confirm the position of the needle. Then, a quick-setting sterile bone cement is injected, stabilizing the fracture and relieving the pain—avoiding the need for prolonged bed rest and narcotics. Vertebroplasty is highly effective and extremely safe, with a less-than 1% incidence of serious complications.
- Kyphoplasty: Kyphoplasty is a similar procedure in which balloons are inflated inside compressed vertebra prior to cement injection. This helps to restore some height, which can be lost with osteoporosis.
- Sacroplasty: Sacroplasty is a cement injection into the sacrum (the bone joining the spine to the pelvis) under CT guidance. Fractures of the sacrum are also usually caused by osteoporosis, and can cause excruciating pain when standing or sitting. Painful sacral fractures may be stabilized instantly with sacroplasty.
Questions?
If you would like to know more about any of these procedures or schedule a consultation, simply call us at 207.956.6650.
