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Understanding Interventional Radiology

Interventional radiology (IR), also known as image-guided surgery, refers to medical procedures performed using image guidance devices such as Magnetic Resonance Imaging (MRI), Computed Tomography (CT), X-rays and ultrasound. Surgical procedures are directed using images, which are obtained with needles and catheters (narrow tubes) through the veins to the disease site.

Interventional radiology is used to diagnose or treat disease, with the advantage of being far less invasive than traditional surgery. Instead of a large incision, IR requires a few small incisions, significantly reducing risk of infection, recovery times and hospital stays.

Interventional radiology procedures include:

  • Ablation, the surgical removal of a body part or tissue, such as a cancerous tumor, without harming the surrounding tissue
  • Embolization, the process of blocking the flow of blood in selected arteries to stop hemorrhaging or to block the blood supply to a tumor
  • Catheter-directed thrombolysis, a procedure used to clear blood clots

The Center for Minimally Invasive Services at WellStar Windy Hill Hospital provides IR, specializing in uterine fibroid embolization as well as other non-invasive procedures.

Uterine Fibroid Embolization (UFE)

Uterine fibroids are non-cancerous tumors of the uterus. Uterine fibroid embolization’s (UFEs) affect one out of three women between 30 and 50 years of age. The most common symptoms of UFEs are heavy menstrual bleeding, pain in the pelvic region and pressure on the bladder or bowel.

Uterine fibroid embolization is a non-surgical, minimally invasive option for treating uterine fibroids. An interventional radiologist uses a high-definition X-ray camera, called a fluoroscope, to guide a catheter into the uterine arteries. Small particles are injected through the catheter to block the blood supply to the fibroids, causing them to shrink and, in most cases, relieve the patient of her symptoms.

The Interventional Radiology Suite in the Center for Minimally Invasive Services at WellStar Windy Hill Hospital has performed more than 1,000 UFE procedures in the past several years and is designed with the comfort of UFE patients in mind.

Before the Procedure

  • An MRI or ultrasound of the uterus is performed to confirm that fibroid tumors are causing the symptoms and to determine the size, number and location of the fibroids.
  • You will likely be told not to eat or drink after midnight the day before the UFE, and which of your usual medications are safe to take the morning of your procedure.
  • Arrange to have someone available to drive you home after the procedure.

During the Procedure

  • Your groin area will be shaved, sterilized and covered with a surgical drape before being numbed with a local anesthetic.
  • Using X-ray guidance, the catheter is inserted into your femoral artery and moved into your uterine arteries. The embolic, or blocking, agent is released into the uterine arteries.
  • Following release of the embolic agent, the catheter is removed, the skin opening covered with a dressing and the IV line removed.
  • UFE usually takes about 90 minutes.

After the Procedure

  • You may go home the same day or spend one night in the hospital.
  • You will need to have someone drive you home.
  • You may experience pelvic cramps, mild nausea and low-grade fever for several days following UFE. The cramps will be most severe during the first 24 hours and should improve rapidly over several days.
  • You will be given pain medication and other prescriptions to take at home. You should be able to return to your normal routine one to two weeks after the procedure.
  • Symptom relief usually takes two to three weeks, and the fibroids will continue to shrink over about six months.

Image-Guided Biopsies

Image-guided biopsies, in many circumstances, have replaced the need for surgical biopsies. In order to obtain samples of tissue for examination, the doctor inserts a small needle, guided by imaging techniques, into the abnormal area. That sample is removed and given to a pathologist for further study.

Before the Procedure

  • Before the procedure, you may receive guidelines about eating and drinking, which may require fasting for up to eight hours before the procedure.
  • Depending upon the imaging technology used, you may be required to ingest a contrast or receive an injection. Make sure you provide your physician with your complete medical history and information about any allergies. Women should tell the physician if they may be pregnant.
  • You will receive specific instructions on how to prepare, which will depend on the exact procedure you have scheduled.

During the Procedure

The procedure for an image-guided biopsy depends upon the type of imaging technology employed. But generally, an interventional radiologist, specially trained in biopsies, will perform the procedure.

  • If an intravenous contrast is required, it will be administered at the beginning of the procedure.
  • Using imaging techniques, the radiologist will examine your body and determine the exact location in which the biopsy will be done. You will be given medication to numb the designated area.
  • Once the area is numb, the doctor will insert a needle into it, continue using imaging techniques to reach the biopsy area and extract tissue.

After the Procedure

  • Pain is the most common problem after treatment. This can be treated with medication prescribed by your physician
  • Because of sedations, you might need someone to drive you home after the procedure.

Endovenous Ablation of Varicose Veins

Varicose veins are abnormally enlarged veins in the legs caused when the valves that allow blood to flow from the legs up to the heart leak. Blood pools in the leg veins causing them to swell. Endovenous ablation is a minimally invasive procedure that diverts blood flow to healthy veins by using heat from radio frequency or laser energy to block the blood flow to enlarged veins.

Before the Procedure

  • Wear comfortable, loose-fitting clothing.
  • A topical anesthetic cream will be applied to the vein area to reduce discomfort.
  • This is usually an outpatient procedure, so arrange to have someone available to drive you home after the procedure.

During the Procedure

  • The area where the catheter will enter the abnormal vein will be numbed with a local anesthetic. The physician will use the ultrasound wand to study the vein and its path.
  • Ultrasound is used to view the enlarged vein. A catheter is inserted into the abnormal vein and laser fiber or a radiofrequency electrode is inserted through the catheter.
  • Local anesthetic is injected around the abnormal vein. Laser or radiofrequency energy is applied and the catheter is slowly removed.
  • Endovenous ablation usually takes about an hour.

After the Procedure

  • You will need to have someone drive you home.
  • You will have to wear a gradient compression stocking to help reduce bruising, tenderness and minimize the rare possibility of blood clots.
  • You may begin normal activity immediately, except for air travel, prolonged sitting or staying in bed. Inactivity increases the chance of complications. You should remain active during the recovery period.


Vertebroplasty is a treatment for vertebral compression fracture caused by osteoporosis. A collapsed vertebra is stabilized by the injection of bone cement into the spine. The procedure greatly reduces pain within hours and can prevent further collapse of the vertebra.

Before the Procedure

  • Diagnostic imaging, blood tests, a physical exam, spine X-rays, a bone scan and/or MRI may be performed to confirm the compression fracture and to determine if vertebroplasty will benefit you.
  • You may be given bone-strengthening medication.
  • You may be instructed not to eat or drink anything for several hours before your procedure.
  • You will need to have blood drawn and tested prior to the procedure to determine if your blood clots normally.
  • Arrange to have someone available to drive you home after the procedure.

During the Procedure

  • You will lie face down for this procedure.
  • Using X-ray guidance, a hollow needle called a trocar is inserted through the spinal muscles until its tip is precisely positioned within the fractured vertebra.
  • The medical cement is injected. It hardens within 20 minutes.
  • A CT scan may be performed to check the distribution of the cement.
  • The trocar is removed.
  • This procedure usually takes about an hour or longer if more than one vertebra is being treated.

After the Procedure

  • You will need to have someone drive you home.
  • Bed rest is recommended for the first 24 hours following vertebroplasty, though you will likely be allowed to go home.
  • You should be able to return to normal activities after the first day, although you shouldn’t do any heavy lifting or strenuous exercise for at least six weeks.
  • Pain relief may be immediate, but it should be gone or reduced in a couple of days.