Interventional radiologists are involved in the treatment of the patient, as well as the diagnosis of disease. They treat an ever-widening range of conditions inside the body from outside the body by inserting various small instruments or tools, such as catheters or wires, with the use of various x-ray and imaging techniques (i.e., CT scanners, MRI scanners, ultrasound scanners). Interventional radiology offers an alternative to the surgical treatment of many conditions and can eliminate the need for hospitalization, in some cases.
The interventional radiologist is a medical doctor who has completed four years of study in radiology. The interventional radiologist is then eligible to take the board examination given by the American Board of Radiology. Following board certification, the interventional radiologist completes an interventional radiology fellowship training program. Today, there are more than 5,000 interventional radiologists in the US, mainly practicing in academic medical centers and in larger community hospitals. Interventional radiologists work closely with other physicians and play an important role on the treatment team.
Interventional radiologists perform a vast variety of procedures, including the following:
- angiography - an x-ray of the arteries and veins to detect blockage or narrowing of the vessels. In many cases, the interventional radiologist can treat the blockages, such as those occurring in the arteries in the legs or kidneys, by inserting a small stent which inflates and opens the vessel. This procedure is called a balloon angioplasty.
- angioplasty - the use of a small balloon on the tip of a catheter inserted into a blood vessel to open up an area of blockage inside the vessel.
- embolization - the insertion of a substance through a catheter into a blood vessel to stop hemorrhaging, or excessive bleeding.
- gastrostomy tubes - a gastrostomy tube (feeding tube) is inserted into the stomach if the patient is unable to take food by mouth.
- intravascular ultrasound - the use of ultrasound inside a blood vessel to better visualize the interior of the vessel in order to detect problems inside the blood vessel.
- stent placement - a tiny, expandable coil, called a stent, is placed inside a blood vessel at the site of a blockage. The stent is expanded to open up the blockage.
- foreign body extraction - the use of a catheter inserted into a blood vessel to retrieve a foreign body in the vessel.
- needle biopsy - a small needle is inserted into the abnormal area in almost any part of the body, guided by imaging techniques, to obtain a tissue biopsy. This type of biopsy can provide a diagnosis without surgical intervention. An example of this procedure is called the needle breast biopsy.
- blood clot filters - a small filter is inserted into a blood clot to catch and break up blood clots.
- injection of clot-lysing agents - clot-lysing agents, such as tissue plasminogen activator (TPA), are injected into the body to dissolve blood clots, thereby increasing blood flow to the heart or brain.
- catheters insertions - a catheter is inserted into large veins for giving chemotherapy drugs, nutritional support, and hemodialysis. A catheter may also be inserted prior to bone-marrow transplantation.
- cancer treatment - administering cancer medications directly to the tumor site.
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