• Delaney Radiologists with Assistant

Interventional Radiology Procedures

At Delaney Radiology, our providers perform several types of minimally invasive, image-guided radiology procedures for specialized diagnostic or treatment purposes. These procedures are referred to as Interventional Radiology, or IR and are sometimes referred to as Special Procedures.  This includes procedures that our radiologists of several sub-specialties and Physician Assistants perform In-House at Delaney Radiology on Medical Center Drive, and In-Hospital. These procedures treat a scope of conditions, creating solutions for a wide range of patients.

In-House Procedure Solutions/Treatments For:

Drainage Procedures—In this procedure, a small amount of anesthetic is administered to numb the area of interest. A needle is inserted to drain fluid collections. Removing fluid will provide relief from pain, pressure and discomfort.

Facet Injection—In this procedure a precise injection of anesthetic and steroid is administered into the small joints of the back for pain relief. Often, multiple injections are performed at different segments to identify which segments are generating pain. The procedure is very important for precise diagnosis and treatment of neck and low back pain.

Spinal Injection—Several procedures can be performed to diagnose and treat pain arising from the lower back, including epidural injections and selective nerve root blocks.  In these procedures, imaging is used to guide a needle into the space around the nerves in order to inject an anesthetic and/or steroid to ease pain and reduce inflammation.  Pain relief can last several months and be repeated multiple times per year as necessary.

Therapeutic Joint Injection—In a procedure that has both diagnostic and pain management purposes, a provider injects an anesthetic and steroid into the joint. The response to the injection determines whether the targeted joint is the cause of the pain, while also providing temporary pain relief that can last from hours to months.

Ultrasound-guided biopsies— In this procedure a small amount of anesthetic is administered to numb the area. A small sample is removed from soft tissue areas and then sent to a lab to determine the make-up of the area of concern.

Aspiration— In this procedure, fluid or tissue is removed from the area of concern using a thin needle and syringe.

Paracentesis— In this procedure, fluid is removed from the abdominal cavity. A catheter is inserted to drain fluid collections. Removing fluid will provide relief from pain, pressure and discomfort.

In-Hospital Procedure Solutions/Treatments For:

We can treat and sometimes cure cancers through pinholes using imaging guidance. If the cancer is small, a skinny wand can be placed into the middle of it and destroy it with cold or heat. This is called ablation. We also treat cancers by finding the blood vessels feeding treat and injecting little beads the give off radiation or chemotherapy to block the blood supply and kill the cancer with radiation or chemotherapy in a “one-two punch.” This is called radioembolization (TARE or SIRT) or chemoembolization (TACE).

Nerve Blocks and Neurolysis— We use imaging to inject medicine to temporary stun or block a nerve causing pain from things like cancer or after surgery. If this helps the pain, some nerve can be permanently destroyed through a minimally invasive procedure called “neurolysis”.

Embolization for Joint Pain— Joint pain is often caused by inflammation, causing extra small blood vessels to grow, causing more inflammation in a vicious cycle. These abnormal vessels can be blocked off (“embolized”), decreasing the inflammation and pain through a pinhole at the top of the thigh, no incision or stitches.

Pelvic Congestion Syndrome— Pelvic congestion syndrome is an old but common term for dilated abnormal veins in the pelvis of women that allows blood to pool there. It can cause chronic deep pelvic pain and pressure/heaviness that tends to be worse at the end of the day, while standing, after sex, and/or during periods. These abnormal veins can be safely destroyed to help with the pain.

Varicoceles and Testicular Pain— Varicoceles are dilated abnormal veins in the scrotum that can cause pain, heaviness, and even infertility. The veins can be safely destroyed through a pinhole at the base of the neck or top of the thigh, no incision or stitches.

Back Fractures— One cause of back pain is a fracture in the spine. This tends to happen when the bones get thin and an otherwise minor slip or fall causes a bone in the spine to break. Through a pinhole in the back, we can fill the fracture with cement, stabilizing it and helping with the pain.

Cirrhosis (or scarring of the liver) can be caused by many things including diet, alcohol, and certain infections. When there is scarring in the liver, it is harder for the blood to pass through creating high pressure in the veins (“portal veins”) taking blood from the bowels and spleen. This is called “portal hypertension.” It can cause fluid to accumulate in the belly (“ascites”) and/or around the lungs. It can also cause abnormal veins to form called “varices” that re-route the blood to bypass the liver. These varices are fragile and can rupture causing life threatening bleeding. They also allow the unfiltered blood to bypass the liver and can cause confusion (“hepatic encephalopathy”). We offer multiple minimally invasive treatments for problems from cirrhosis including transjugular biopsy and pressure measurements, TIPS placement and revision, transvenous obliteration, and partial splenic embolization.

Image-guided biopsies, angiography and venography, transjugular liver biopsy

Biliary, nephrostomy, and abscess drain placement, checks, and exchanges

As men get older, their prostates tend to get bigger, which is called BPH or BPE. This doesn’t always cause problems but can make it difficult to urinate, feel like you can’t hold it, and urinate multiple times throughout the night. Prostate artery embolization is a minimally invasive solution for enlarged prostates causing problems. This is an outpatient procedure where some of the blood supply to the prostate is blocked off with tiny permanent beads, causing the prostate to shrink.

Feeding tube placement, exchange, and revision

Fibroids are common, benign (not cancer) growths in the uterus. Some fibroids cause problems such as heavy bleeding, pain, constipation, and frequently having to urinate. These can be treated with a minimally invasive, outpatient procedure called uterine fibroid embolization, where some of the blood supply to the uterus and fibroids is blocked off with tiny permanent beads, causing them to shrink.

Paracentesis, Thoracentesis, Tunneled drain placement

Hemorrhoids can become enlarged and problematic from chronic constipation, straining, and childbirth. When these get enlarged, they can cause problems such as bleeding and pain. Hemorrhoid embolization is a minimally invasive solution for hemorrhoids causing problems. This is an outpatient procedure where some of the blood supply to the hemorrhoids is blocked off with tiny permanent beads and coils causing the hemorrhoids to shrink. This is done through a pinhole in the wrist or top of the leg, so no incision or stitches.

PICCs, tunneled dialysis catheters, port placement, revision, and removal

For further detail about interventional radiology, visit the Interventional Initiative’s site devoted to IR procedures awareness.