The Ultimate Guide to Choosing a Medical Specialty by Brian Freeman

Author:Brian Freeman
Language: eng
Format: epub
Publisher: McGraw-Hill Education
Published: 2019-09-22T16:00:00+00:00

WHAT IS INTERVENTIONAL RADIOLOGY?

Unlike most fields which are based on a single organ system, disease process, or type of patient, interventional radiology is based on a set of imaging and procedural techniques that can be applied to nearly every disease and patient population. While its roots began in treating vascular disease, interventional radiology has expanded into many areas including oncology, women’s health, trauma, neurologic, pediatrics, and pain management. While some interventionalists choose to focus on certain areas, most prefer to be general interventionalists and enjoy the variety of their practice.

From infantile hemangioma to end-of-life cancer palliation, and acute stroke thrombectomy to peripheral artery disease, interventional radiology is truly a head-to-toe, cradle-to-grave specialty. Fundamentally, interventional procedures typically follow a similar pattern—needles, catheters, and wires are directed under image guidance either endovascularly or percutaneously to the targeted pathology where a treatment is delivered. For example, for certain tumors, such as hepatocellular carcinoma, interventional radiologists can navigate a guidewire and catheter endovascularly directly to the tumor’s blood supply and deliver chemotherapy or radiation eluting beads straight to the tumor, sparing the adjacent healthy tissue and systemic side effects. For another example, with uterine fibroids, interventional radiologists can identify the feeding arteries and place coils to occlude blood flow to shrink the growths. Similarly, these coils and other embolic techniques are used to stop hemorrhage from trauma or surgical complications. Interventional radiologists can also access their target directly by placing a needle, probe, or tube percutaneously under ultrasound or CT. Hepatic tumors can be accessed through a probe and treated using ablation: a method of treatment that heats or freezes the tissue. Interventional radiologists can also place drainage tubes for abscess, chest tubes for pneumothorax, and gastrostomy tubes for feeding. With skillful navigation, they can biopsy tissue even deep in the torso. The scope and practice of interventional radiology has rapidly expanded as these techniques can be utilized in many organ systems to offer minimally invasive alternatives to current therapies.

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