Interventional Radiology, Including Aneurysm Coiling and Chemoembolization.

What is interventional radiology?

Interventional radiology refers to special imge-guided procedures that allow minimally-invasive access to the body. The most common interventional radiologic procedure is angiography, in which a catheter is introduced through a tiny hole in an artery (usually the leg), and advanced through the arteries to the organ that is being evaluated. Angiography may be used to unblock vessels, deliver medications, and block blood supplies to tumors or other abnormal masses.

What should I expect?

You will be asked to arrive to the medical center several hours prior to your scheduled procedure. Before the procedure, our staff will take a brief health history, monitor your vital signs, and may perform laboratory tests ordered by the radiologist. Your procedure will be done in a diagnostic imaging suite, using one or more imaging technologies to identify and target the area to be examined. There are several different types of interventional procudres, and yours will be explained to you prior to entering the imaging suite.

How should I prepare?

Your preparation is specific to the type of interventional procedure your clinician has recommended. Prior to your arrival at the medical center, you will receive specific pre-procedural instructions that may included restricting your diet and refraining from your medication.

How do I get the results?

After your interventional radiology procedure is complete, the TRG radiologists will review your study and report the findings to your ordering physician. Follow up with your physician for scan results and care plan.

Your interventional radiology procedure can be performed at:

Aneurysm Coiling

What is a brain (or cerebral) aneurysm?

A brain aneurysm is a balloon like pouch that develops from a weakened artery wall. Aneurysms are most frequently detected between the ages of 40 and 60a and are more common in women than men. Aneurysms have the risk of rupture and bleeding, creating complications that can be potentially life threatening.

How is an aneurysm detected?

Aneurysms can be detected with imaging studies such as an MR angiogram (MRA), CT angiogram (CTA), or angiography. These studies are often ordered when your physician feels that there may be a vascular abnormality in your brain.

How is an aneurysm treated?

If an aneurysm ruptures or breaks, the treatment must be immediate. If an aneurysm is detected in tact, it may be treated with a cerebral coil or surgery. There are certain aneurysms that physicians choose not to treat.

If you or a family member have been diagnosed with an aneurysm it is important to discuss your treatment options with your physician.

What is aneurysm coiling?

Aneurysm coiling is a less invasive way of treatment. A catheter (small plastic tube) is placed in the artery in the groin. The catheter is guided through the artery network and directly to the aneurysm. Once there a small coil made of platinum are threaded through the catheter into the aneurysm. The coil prevents blood entering the aneurysm and protects it from rupturing.

What to expect.

Prior to having your unruptured aneurysm treated, you will have a thorough consultation our Interventional neuroradiologist. Procedures will be discussed in detail and all of your questions will be answered during your consult.

The procedure is performed under general anesthesia. You will stay in the hospital overnight and go home the next day. You may return to normal activity within a few days. You may experience a headache or soreness in the groin after the procedure. Pain medication will be prescribed to keep you comfortable.

Your interventional radiology procedure can be performed at:

Chemoembolization

What is Chemoembolization?

Chemoembolization or Y-90 treatment is a palliative treatment for liver cancer. The cancer can either originate in the liver or be one that has spread or metastasized to the liver. During this procedure, 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 oils and tiny particles.

This procedure:

  1. Deprives oxygen and nutrients to the tumor once the blood supply is blocked
  2. Permits 20 to 200 times greater chemotherapy doses than those injected into a vein in the arm.
  3. Blocks the hepatic artery so no blood washes through the tumor, which results in the drugs staying in the tumor for a much longer time.
  4. Decreases side effects because the drugs are trapped in the liver instead of the circulating throughout the body.

How does Chemoembolization work?

Chemotherapy drugs are injected into the hepatic artery at the liver and reach the tumor very directly, sparing most of the healthy liver tissue. Then, when the artery which is the major blood supplier in cancer patients is blocked, nearly all of the blood is taken away from the tumor, while the liver continues to be supplied by blood from the portal vein.

When eoes a physician recommend this procedure?

Chemoembolization only treats tumors in the liver and has little effect on any other cancer in the body, the following liver cancers may be treated by Chemoembolization:

  • Hepatoma (primary liver cancer)
  • Metastasis (spread) to the liver from:
  • Colon cancer
  • Carcinoid Cancer
  • Ocular melanoma
  • Sarcoma

Our radiologist may recommend that you have several tests, including liver function blood tests, and a CT scan or an MRI of your liver prior to the Chemoembolization procedure. These tests are done to assure that there is not:

  • Blockage of the portal vein
  • Cirrhosis of the liver
  • Blockage of the bile ducts

Any of these complications, may prevent a Chemoembolization procedure.

How do you prepare for the procedure and what you should expect

The evening before the exam you may not eat or drink anything after midnight. You will be instructed which medications you may take in the morning, and when to arrive at the hospital. After completing admission paperwork you will be sent to the Special Procedures Area where you will have an intravenous (IV) line placed in your arm, and a catheter will be placed into your bladder. Fluids, antibiotics and anti-nausea medication will be given prior to your procedure. You will then be sent to the Interventional Angiography Suite. Here you will meet with our Interventional Radiologist) and nurses/technologists trained in this procedure. You will be given sedation for relaxation and pain, but you will be conscious during the procedure.

First, the radiologist will place a small tube in an artery in your groin and perform an arteriogram ( X-ray study of the arteries ) by injecting a contrast agent into your arteries of your liver. After these arteries are identified, the catheter is directed into the branch of the artery supplying blood to the tumor. Chemoembolization mixture is then injected. Once this is completed, you are sent to your hospital room where you will lie flat in bed for six hours. More IV fluids are given to you overnight. Most patients are able to leave the hospital the next day.

Are there any side effects or complications?

Following the procedure you may have varying degrees of pain, fever and nausea. These symptoms may last a few hours to a few days, and are treated with medication. You may also notice slight hair loss, rarely noticed by anyone other than yourself.

Serious complications from chemoembolization are rare. In less that 3% of the procedures, the liver tumor killed by the procedure may become infected and abscess. There has been one fatality in 100 procedures due to liver failure.

Will Chemoembolization help me?

Chemoembolization is a treatment, not a cure. Approximately 75% of the patients will see improvement in their liver, and depending on the type of liver cancer, it may improve your chances of survival.

For additional information or to schedule a chemoembolization procedure, please contact us.

Your Interventional Radiology procedure can be performed at: