What Is Interventional Radiology (IR)?

Interventional radiology (IR) is the use of medical imaging techniques to guide doctors as they diagnose and treat certain problems with blood vessels and lymph vessels throughout the body. IR is also called image-guided therapy.

Who Does Interventional Radiology (IR) Procedures?

Interventional radiology tests and treatments are done by interventional radiologists. These doctors are specially trained in anatomy and image guidance.

They treat kids who have lymphatic system and vascular (or circulatory) system disorders. These problems can be congenital (present at birth) or acquired (starting after birth). Interventional radiologists use small specialized equipment and precise imaging to diagnose and treat these and many other disorders.

Who Gets Interventional Radiology (IR) Treatments?

Doctors may send patients to an interventional radiologist for many different reasons. Most children who get IR have a tumor or a vascular problem that's treated with image-guided therapies instead of (or along with) traditional surgery or medical therapy.

IR also is done to help kids who have narrowing of their blood vessels or, more rarely, an aneurysm. If a child has a buildup of pus or fluid, IR might be done to safely place drainage tubes with a smaller procedure than open surgery. IR can also guide biopsies (getting small pieces of tissue to check under a microscope) when an unknown mass is found.

What Happens During an Interventional Radiology (IR) Procedure?

In IR procedures, interventional radiologists use an imaging technique — such as an ultrasound, CAT scan , live X-ray diagnosis, or fluoroscopy — to produce a real-time image. This guides them as they do things like:

• an angiography (to study inside of blood vessels and treat things like narrowings or aneurysms)
  
• bone/tumor treatments (to place small needles inside tumors and make them disappear while protecting surrounding tissue)
• drain placements (to remove fluid buildup in the lungs or abdomen)
• joint aspirations or steroid injections (for injury, arthritis, or inflammation)
• insert central lines for treatment (PICC lines, ports, dialysis catheters, etc.)
• drain an abscess (infection)
• GI procedures, such as placing nasojejunal (NJ) or gastrostomy feeding tubes
• place a chest tube (to drain fluid or pus from the lungs)
• a biopsy (taking a tissue sample of a tumor or organ)
• treat vascular malformations, including:
  • venous malformations
  • lymphatic malformations
  • arteriovenous malformations
  • some kinds of hemangiomas (abnormal tumors with blood vessels in or under the skin or inside internal organs)
• treat bone and soft tissue tumors using ablation technologies to make them disappear, including:
  • radiofrequency ablation (high-energy radio waves that heat and destroy cancerous cells)
  • microwave ablation
  • cryoablation (using freezing cold temperatures to treat tumors)
• treat bleeding and painful skin lesions that happen with vascular malformations by using lasers to destroy vascular bumps on the skin that bleed called vesicles (this is called photoevaporation)

What Are the Benefits of Interventional Radiology (IR) Procedures?

Treatments done by interventional radiologists are minimally invasive. Because they use small incisions (cuts), IR procedures often are less painful than regular surgery. Children get the smallest amount of anesthesia or sedation necessary to be safe and comfortable during an IR procedure.

Patients usually have shorter recovery times and very small or no scars. Many times, IR treatment doesn't require a hospital stay.

Because IR treatments are image-guided, they can be very precise. This helps doctors prevent as much damage as possible to surrounding tissue, organs, and skin.