Interventional radiology at Derby Hospital

What is interventional radiology?

Interventional radiology (IR) uses medical scanning, X-ray, CT and ultrasound among the options, to guide minimally invasive procedures inside the body. It's sometimes described as image-guided surgery.

What conditions does interventional radiology treat?

Interventional radiology can be used for:

• narrowed or blocked arteries (peripheral vascular disease)
• internal bleeding, including after childbirth, following an injury, or from the gut
• blood clots, including those affecting the lungs (pulmonary embolism)
• uterine fibroids
• an enlarged prostate causing urinary symptoms
• kidney or liver problems, such as a blocked kidney or bile duct
• collapsed bones in the spine
• some cancers, as part of diagnosis, treatment or palliative care

What are the benefits of interventional radiology?

Interventional radiology procedures are usually carried out through an opening smaller than keyhole surgery, sometimes called pin-hole surgery since the entry point is often no wider than a large needle.

Compared with open or keyhole surgery, this generally means a quicker recovery, a shorter spell away from work, and lower costs.

Most procedures can be done using local anaesthetic, sometimes combined with sedation, and a general anaesthetic is only needed for a small number of complex cases.

Are there different types of interventional radiology procedures?

Interventional radiology covers a broad range of procedures, including:

• vascular procedures on arteries, such as angioplasty (widening a narrowed vessel with a balloon) or embolisation (blocking a vessel to stop bleeding or cut off blood supply to a tumour)
• vascular procedures on veins, such as line insertion, placing a filter to stop blood clots travelling around the body, or removing a clot directly (thrombectomy)
• non-vascular procedures, such as unblocking a kidney or bile duct, injecting cement into a collapsed spinal bone (vertebroplasty), or placing a feeding tube
• interventional oncology, treating tumours directly, for example by heating them (ablation) or delivering treatment through their blood supply
• targeted pain relief, such as spinal or joint injections

Some procedures have their own specific names, such as uterine artery embolisation for fibroids, prostatic artery embolisation for an enlarged prostate, and endovascular aneurysm repair (EVAR), carried out through a small opening in the groin to treat a swelling in the aorta.

What happens before interventional radiology?

You may need to fast beforehand, particularly if you're having a general anaesthetic; your team will confirm what applies to your specific procedure.

If there's any chance you could be pregnant, it's important to say so before your appointment, since procedures involving radiation can't go ahead during pregnancy. You may be advised to avoid unprotected sex from the first day of your last period until your appointment, to help rule this out.

What happens during interventional radiology?

Exactly what happens depends on the procedure, but most follow a similar pattern: a needle is guided into position using ultrasound or CT imaging, then a fine wire and a thin tube called a catheter are passed through it to reach the artery, vein or organ being treated.

Live X-ray imaging then helps your interventional radiologist direct that wire and tube to the site involved and carry out the procedure, working alongside specialist nurses and radiographers throughout.

What does recovery look like?

Because the opening used is so small, recovery is generally quicker than after open surgery, and many procedures can be carried out as a day case, meaning you go home the same day.

Your specific aftercare advice depends on which procedure you've had, so your team will talk you through what to expect for your particular case.