Interventional Radiology

Interventional Radiologists are board-certified physicians who specialize in minimally invasive treatments for disease using image guidance. At St. Joseph’s Imaging Associates, radiologists perform many of these procedures in our outpatient interventional office located in the Northeast Medical Building in Fayetteville.

The improved ability of radiologists to see inside the body gave rise to targeted treatments for uterine fibroids, osteoporosis, breast treatment and vascular disease. Consultations for these conditions are done in our office. Suggested treatment is then scheduled with our interventional department, 315-362-8346.

Interventional Radiology exams are only performed at our Northeast Medical Building in Fayetteville.

Varicose Vein Ablation

Superficial venous insufficiency is a common but disabling disease that can be effectively treated in our outpatient center. A thorough understanding of a patient’s venous anatomy is essential. In a normal vein, one-way valves keep the oxygen-depleted blood flowing from the legs toward the heart. If these valves weaken they allow blood to flow back down the legs, a condition called reflux. There the blood pools, often causing pain and unsightly swollen vessels or varicose veins.

At our office, patients are examined and the proper vascular treatment is then prescribed and performed by the interventional team. Recommendations may be as simple as cosmetic improvements with sclerotherapy. Other patients may require complete vein removal or endovenous ablation.

For an appointment, please call our Vein Line at (315) 362-VEIN (8346), or by emailing [email protected].

Ambulatory Phlebectomy

Ambulatory phlebectomy requires a local anesthetic. It is done using a light source to locate the vein and a surgical hook to remove it. A series of small incisions are made in the leg and the hook pulled through them. Very large veins can be removed with minimal scarring. Patients can return to their normal activities the day after treatment.

Uterine Fibroid Embolization

Uterine fibroids are benign tumors that occur in the uterus. It is estimated that 40% of all women have uterine fibroids but only about 25% are symptomatic. The most common symptom is increased or abnormal menstrual bleeding. Other symptoms may include pelvic pain, bloating and urinary incontinence or frequency.

Fibroids are usually diagnosed on physical examination and with a pelvic ultrasound or MRI imaging. Surgical options for fibroids include myomectomy and hysterectomy. Myomectomy is the removal of the fibroid only, while hysterectomy is the complete removal of the uterus.

Uterine fibroid embolization is a minimally invasive procedure for the treatment of symptomatic uterine fibroids. Fibroids depend on a very rich blood supply. Embolization interrupts this blood supply. To perform this procedure, the radiologist performs an angiogram. A small catheter is inserted into the groin and advanced to the uterine arteries supplying the fibroids.

Small particles are then injected into these vessels. These particles block the blood supply to the fibroids causing them to shrink or degenerate. Following the procedure, bleeding stops immediately. Tumors decrease in size over the following several weeks.

The interventional radiologists at St. Joseph’s Imaging are available for consultation regarding this procedure.

For additional information regarding interventional radiology, please visit theSociety of Interventional Technology.

Sclerotherapy

Sclerotherapy is a simple procedure performed on superficial veins. Generally these veins are not problematic but unsightly in appearance. Therefore most of these procedures are done for cosmetic reasons. The treatment involves an injection of a solution into the vein that causes the vein walls to swell, stick together and seal shut. Once the vein is shut there is no blood flowing in it and it turns into scar tissue. It usually takes about two weeks for the scar to fade. Sclerotherapy does not require any anesthetic and is performed in our outpatient interventional department.

For an appointment, please call our Vein Line at (315) 362-VEIN (8346), or by emailing [email protected].

Peripheral Vascular Disease

Fat and cholesterol can accumulate on the inside of arteries and form deposits called plaque. This disease process is called arteriosclerosis. The arteries that supply blood to the brain, kidneys or legs can be narrowed or blocked by this accumulation. For example, narrowing of the arteries to the legs can cause pain while walking (Claudication) and similar disease in the arteries to the kidneys can cause high blood pressure, while plaque in the arteries to the brain (Carotid arteries) can cause a stroke.

The procedure starts with the patient lying on a padded table. Local pain medicine is given, and the catheter is then inserted in an artery (usually near the groin). The catheter is a small, hollow, flexible tube that has a balloon near the end of it. The patient is awake for the procedure, but is given sedation for relaxation and to minimize pain.The blood vessels are then visualized by using X-rays and contrast, and blockages in the vessels are identified. A balloon catheter is then inserted into the blockage and inflated, thus widening or opening the blocked vessel and restoring adequate blood flow. In almost all cases, a device called a stent is also placed at the site of narrowing or blockage in order to keep the artery open. A common type of stent is made of self-expanding, stainless steel mesh.

For additional information regarding interventional radiology, please visit https://www.sirweb.org/patient-center/peripheral-arterial-disease/.

Vertebroplasty / Kyphoplasty

A safe and effective treatment for the pain associated with compression fractures of the spinal vertebrae can be achieved by a procedure called percutaneous vertebroplasty. The typical indications for the procedure are patients with acute or subacute vertebral fracture not responding to medical pain management. Also, patients who cannot tolerate pain medications due to gastrointestinal complications or allergies are suitable candidates. Painful fractures due to a metastatic tumor within vertebrae can also be treated with this technique. Performed in the radiology suite, the procedure involves placement of a needle into the fractured bone, then injecting a special cement to stabilize the bone. This results in reduced pain.

For additional information concerning vertebroplasty, visit The Society of Interventional Radiology to learn more.

Varicose Vein Treatment

What are Varicose Veins?

Varicose veins are enlarged veins that can be blue, red or flesh colored. They are often raised above the skin on legs and look like twisted bulging cords. Varicose veins occur when the valves in the veins that regulate blood flow direction from the legs toward the heart no longer function, causing blood to pool. Symptoms of varicose veins include pain, swelling, aching, throbbing, burning, cramping and heaviness.

Endovenous Radiofrequency Ablation (RFA)

RFA is a minimally invasive procedure using segmental radiofrequency energy to provide an even and uniform heat to contract the collagen in the vein walls, causing them to collapse and seal the vein closed. Blood flow is then naturally redirected to healthy veins as the recovery process begins. The treated vein becomes scar tissue and is eventually absorbed by the body and blood is then re-routed through healthy veins back towards the heart. We do this without general anesthesia, sutures or down time. Your leg will feel relief within 24 hours.

Ambulatory Phlebectomy

A non-invasive procedure to remove varicose vein branches by micro-extraction technique. Tiny incisions are made in the skin through which the remaining varicose veins are removed. The incisions are so small they do not require stitches, and often heal without scarring. It is performed as a second stage to the RFA treatment or when there are isolated varicose veins.

After The Treatment

After the treatment, compression stockings can be worn to help with healing and decrease swelling for the following two weeks. You may resume normal activity after the treatment but no strenuous or heavy lifting for up to two weeks. Mild soreness may last up to ten days. A follow-up ultrasound will be scheduled two weeks after treatment.

Prospective patients must complete a survey to determine their eligibility for treatment:

Deep Vein Thrombosis (DVT)

Deep Vein Thrombosis, or DVT, is a large blood clot that forms in one or more of the deep veins in your body. DVT usually happens in the legs or pelvis, but a clot can form anywhere in your body. This can lead to either partially or completely blocked venous circulation. Symptoms may include pain, swelling, redness, warmness, and enlarged veins near the surface of your skin.

IV clot busters, or thrombolytics, are medications placed directly into the clot during a minimally invasive procedure. They’re designed to quickly dissolve clots and restore blood flow.

Thrombectomy devices are special catheters designed to help break up and physically remove all or portions of the blood clot during a minimally invasive procedure.

IVC Filter

An IVC Filter is a small metal device designed to prevent blood clots from traveling to the lungs. The filter is placed in the inferior vena cava (the large vein that takes blood back to the heart) typically just below the kidneys using a catheter type deployment device.

A catheter is inserted through a small incision in your groin or neck into a large vein. The physician uses the catheter to guide the filter into place in the inferior vena cava under x-ray guidance. The vena cava is imaged and sized prior to filter deployment. The catheter is removed, and a small bandage is placed over the insertion site.