Venous Conditions Treated with IR
Deep Vein Thrombosis
Deep vein thrombosis is when a blood clot forms in one of the major veins deep inside the body. It most commonly occurs in the legs – lower leg, pelvis, or thigh. It can also occur in other parts of the body. Symptoms of deep vein thrombosis include leg or arm swelling, pain or soreness when standing or walking, enlarged veins, and skin that looks red or blue. To treat deep vein thrombosis, interventional radiologists perform thrombolysis, a thrombectomy or a filter or stent placement.
Thrombolysis is a catheter-directed procedure that treats blood clots within the arteries or veins and improves blood flow by dissolving abnormal blood clots. X-Ray imaging is used for guidance. A blood clot, also known as a thrombus, can block off blood supply to certain parts of the body, which may cause serious damage. Using the x-ray and a catheter, the doctor is able to direct a special medication or medical device to dissolve the blockage, remove it, or prevent the artery or vein from becoming permanently blocked. Due to the medications used, this procedure may require a longer, overnight stay in the hospital. An overnight stay will also allow doctors to determine the initial cause of the blood clot.
Inferior Vena Cava Filter Placement/Removal
An inferior vena cava filter is a small filtration device inserted by an Interventional Radiologist that prevents blood clots from reaching the lungs, which causes a pulmonary embolism. The inferior vena cava (IVC) is the vein that is largely responsible for returning oxygen-deficient blood from the lower body to the heart. The filter is placed by running a catheter up the IVC directed by image guidance technology. When the catheter releases the filter, it expands and attaches itself to the walls of the IVC.
When the risk of a pulmonary embolism has passed, an IVC filter may be removed. This is done by running a catheter through the IVC to reach the filter. Once the catheter reaches the filter, the catheter grabs the IVC filter and both the filter and catheter are removed from the body.
Venous Stent Placement
A venous stent is a small, metal, mesh-like tube that is utilized when there is a blockage due to blood clots or damage to a vessel wall. Prior to a venous stent, an angioplasty is typically attempted. If there is failure of the angioplasty, the venous stent is placed. There are two types of venous stents; balloon-expandable or self-expanding. Some of these stents are bare-metal while others are covered.The appropriate type of stent will be chosen depending on the type of lesion. To insert the venous stent, the balloon placed during the angioplasty is removed and a catheter is inserted with a stent attached to the end. When the stent is placed in the appropriate location, it applies pressure to the walls of the vein to keep it open and allow for better blood flow.
A thrombectomy is a procedure to remove a blood clot from a vein or artery. During this procedure, the doctor will insert a thin catheter into the leg or groin through a small puncture site. The catheter is guided to the blood clot utilizing a contrast dye to locate the blood clot location. A device at the end of the catheter breaks up the blood clot. A thrombectomy in an outpatient setting will take between 2 and 3 hours to complete.
Varicose veins are twisted, swollen veins usually located in the legs. They are commonly caused by incompetent valves. When valves within veins are leaking, blood pools resulting in enlarged varicose or spider veins. Three interventional radiology procedures are performed to treat varicose veins including sclerotherapy, ambulatory phlebectomy and endovenous thermal ablation.
Sclerotherapy is a tool used to help treat varicose vein disease. An ultrasound is used to locate the diseased vein and a specialized medication is injected into the vein. This causes the vein to close and shrink over time.
Ambulatory phlebotomy is a procedure that is used to treat varicose veins that are just under the surface of the skin. This procedure uses micro-incisions to remove the vein which not only improves cosmetic appearance but also improves symptoms.
Endovenous ablation is a procedure that is used to treat varicose veins. An ultrasound is used to guide a catheter inside of a diseased vein. Depending on the type of treatment, the vein is closed using either a laser, radio frequency or a sterile type of glue. Overtime, the vein will shrink and be absorbed.