Often a patient can have a medical procedure done without having an open surgery.  Minimally invasive procedures, which do not require large incisions, are normally performed by an interventional radiologist. These radiologists are skilled in reading x-rays, ultrasound, MRI and CT, and in guiding small instruments, such as catheters into blood vessels and other paths into the body to treat conditions percutaneously, or under the skin. Because these procedures do not involve large incisions, patients typically recovery more quickly and have less pain afterwards.  

Atlanta Radiology has several board-certified and fellowship trained interventional radiologists on staff to perform such procedures as vascular stenting, nephrostomy, biliary drainage, abscess drainage, central venous access, embolization to stop bleeding, gastrostomy tubes and TIPS (transjugular intrahepatic portosystemic shunt). 

If a patient has a partial or total blockage of their ureter (the long tube that carries urine from the kidney to the bladder), it can result in kidney damage.  A percutaneous nephrostomy tube – a soft, rubber catheter – can be inserted into the lower back into the kidney, serving as a bypass around the blocked region.  Urine is collected into a bag.  Some patients require only one bag, and will still be able to void as urine will collect normally in the other kidney. The tube is placed using x-ray or ultrasound guidance. It stays in place as long as the blockage is present or in cases where there is a hole in the ureter, until the hole has healed.

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Bile is a body fluid that helps the body digest fats. It is produced in the liver, stored in the gall bladder and is eventually carried to the small intestines to aid in digestion. When one or more of the ducts that carry bile narrows or becomes blocked, patients become jaundiced, characterized by a yellowing of the skin. In some cases, the bile may leak into the abdominal cavity. By using x-ray, Percutaneous Transphatic Cholangiography allows the interventional radiologist to see if the ducts are partially or completely blocked. If there is a blockage, the radiologist can insert a tiny tube into the duct and create a drainage path directly into the intestines or a collection bag outside the body. If a bag is required, it will remain in place until the blockage is removed or the duct repaired.  In some cases, a stent, or small mesh tube, can be put in place to open up the duct permanently.

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When a patient has a collection of bacteria in the body, an abscess can form.  Abscesses occur more commonly in patients with Crohn’s Disease, following trauma, surgery or due to an intestinal perforation. Abscesses can also result from minor breaks in the skin, obstructed sweat or oil glands and inflammation of hair follicles. Patients experience pain and discomfort, fever, chills and sweating.  It’s critical to treat an abscess very quickly as the infection can impair blood flow to the neighboring areas of the body and result in a loss of limb, if it is ignored.

An abscess is typically treated by inserting a catheter to drain the infection from the body. An ultrasound or CT scan can detect the site of the abscess.  Under CT guidance, an interventional radiologist inserts a catheter to drain the abscess and remove the infection from the body. In the past, surgery was often required to relieve the infection, but is used in only extreme cases.

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When a patient needs a long-term central IV line to receive chemotherapy, antibiotics or nutritional fluids, a peripherally inserted central catheter (PICC) can be placed in the patient’s peripheral vein to a void repeated needle insertions. While many hospital patients benefit from PICC lines, these central lines can help patients go home and receive therapy on an outpatient basis. PICC lines, which can also be used for blood samples, can be left in place for many months.  An interventional radiologist or nurse places the PICC line into a large vein of the arm above the bend of the elbow. It is then moved into a large vein just above the heart.  The tube can have several spaces to allow for different treatments to be delivered at the same time.  When the tube is not in use, a clamp keeps it closed.

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Patients in kidney failure have to undergo regular hemodialysis to clean their body of toxins. To keep them from having repeated needle insertions and to preserve their veins, an interventional radiologist can insert a tunneled or temporary catheter in a large vein of the neck. The tunneled catheter may be left in place for up to a year, allowing access to the veins, without the additional discomfort to the patient. This access is especially important in patients who have no other access for hemodialysis.

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The human spine is a complex, flexible system made up of vertebrae, sacrum and tailbone. Between the vertebrae are pads called discs that take the shock from daily activities. The spine is the support system for the body, but its delicate design can result in many problems. The most common issue for adults is herniated or “slipped” discs, which happens when there is a tear in the disc. The rupture can cause pain, numbness, and weakness. While a herniated disc most often occurs in the lumbar spine, it can also happen in the cervical and thoracic areas. Other spinal problems include arthritis, called spinal stenosis, osteoarthritis, degenerative disc disease, osteoporosis, spondylolisthesis, scoliosis, kyphosis and trauma resulting in breaks in the vertebrae.  

Atlanta Radiology’s specialty trained radiologists can diagnose and treat many conditions through minimally invasive procedures and pain management therapies.

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Bone loss from osteoporosis can lead to a painful vertebral compression fracture (VCF). More than 750,000 older adults are diagnosed with a VCF each year.  Often a patient notices acute back pain and in 90 percent of the cases, conservative therapy of medications and bed rest is successful. In some cases, patients do not heal properly and are left with chronic pain. Those patients can benefit from two minimally invasive procedure performed by an interventional radiologist.

Kyphoplasty is a technique that allows for the restoration of vertebral height. Using fluoroscopy guidance, a balloon is inserted into the affected vertebral site and is inflated to reduce the fracture and create a void for cement deposition. The balloon is removed and replaced with bone cement, which in injected into the site. This procedure stabilizes the vertebrae and usually brings immediately pain relief to the patient.

Vertebroplasty is similar to kyphoplasty as cement is injected directly into the vertebral body, but does not use a balloon to restore the height of the bone.

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Myelograms are an effective way to examine the spinal canal and spinal cord.  The test is especially helpful to determine is there is a herniated disc, lesion, tumor, bone spur or nerve root problem that is causing back pain in a patient. While the procedure is traditionally performed using an injected dye into the patients back and following it with fluoroscopy, CT scan is often used to get a cross-sectional view of the spine.

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It’s estimated that 1.4 million people in the United States are diagnosed with cancer each year. The most common cancers in adults– lung, breast, prostate and colorectal cancers – can be diagnosed through imaging and treated more successfully if found in the early stages. According to the American Cancer Society, there are seven warning signs of cancer that people should recognize and talk to their physicians if noticed.  They are:  

• A change in bowel or bladder habits
• A sore that does not heal
• Unusual bleeding or discharge from any place
• A lump in the breast or other parts of the body
• Chronic indigestion or difficulty in swallowing
• Obvious changes in a wart or mole
• Persistent coughing or hoarseness

Atlanta Radiology uses a variety of imaging – x-ray, mammography, CT scan, MRI, ultrasound and PET•CT to diagnose cancers, and offers state-of-the-art, innovative cancer therapies to treat liver cancer.

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Radiofrequency ablation is a minimally invasive procedure for patients who have either certain tumors not treatable by traditional surgery or chemotherapy. An interventional radiologist performs the procedure which delivers heat to the tumors to destroy the cancer, while sparing nearby tissue. Using CT or ultrasound guidance, the radiologist threads a needle electrode to the tumor site, where radiofrequency current is directed at the tumor. The heat ablates the tumor and seals the site to control bleeding. This outpatient procedure is often recommended in patients who are not good candidates for surgery. In patients where the tumor is too large for surgery or there is limited access for surgery, radiofrequency ablation is an effective treatment. The procedure is also a next step for patients who have failed to respond to chemotherapy or surgery.

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Another effective way to treat either a primary or secondary liver cancer is by delivering chemotherapy directly into the cancer cells. Using x-rays to visualize the liver, an interventional radiologist inserts a catheter into an artery in the groin and guides it to the artery adjacent to the liver. Chemotherapy is injected into the tumor where it cuts off the blood flow to the cancer cells, depriving the tumor of oxygen and nutrients to survive. Chemoembolization delivers a one-two punch, by directing chemotherapy into the tumor and containing the drugs at the site to block the blood supply that feeds the tumor. Chemoembolization spares the rest of the body from the effects of chemotherapy. It is often used as a first-line treatment for smaller tumors of the liver or used in conjunction with surgery or radiation.

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This new therapy is called Selective Internal Radiation Therapy also known as SIRT. This technique uses millions of tiny polymer beads or microspheres which contain a radioactive element called yttrium-90. The microspheres are very small, approximately 32 microns in size, and are about one-third the diameter of a strand of hair. SIRT is usually administered as an outpatient procedure. A small catheter is guided into the arteries of the liver and the microspheres are infused through the catheter directly to the tumors where they preferentially lodge in the small vessels feeding the tumor and deliver their dose of radiation. Unlike conventional external beam radiation, which can only be applied to limited areas of the body, Y-90 microspheres selectively irradiate the tumors and therefore have the ability to deliver more potent doses of radiation directly to the cancer cells over a longer period of time with fewer side effects.

Uterine fibroids are very common noncancerous (benign) growths that develop in the muscular wall of the uterus. Although hysterectomy, performed by a gynecologist, is the most common treatment for symptomatic uterine fibroids, most women are candidates for the uterine fibroid embolization (UFE), a widely available nonsurgical option. UFE, also known as uterine artery embolization, blocks the blood flow to the fibroid tumor, killing it and causing symptoms to subside.

This targeted therapy is most often used for freezing of some forms of cancer inside the body. In these cases, interventional radiologists perform the minimally invasive procedure under the guidance of ultrasound or CT. Patients are typically sedated prior to the procedure. A small prick is made in the patient’s skin and a tiny wand called a cryoprobe is inserted at the site. Imaging technology directs the radiologist to the diseased tissue or tumor inside the body, where either liquid nitrogen or argon gas is used to freeze and destroy the cells via the needle. Since living tissue cannot survive in extreme cold, the treatment effectively kills off the cancerous cells.  Cryotherapy is normally performed on an outpatient basis.

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