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Interventional Radiology
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Interventional Radiology

Interventional Radiology
Interventional radiology is a specialized grouping of radiology-based diagnostic services and procedures, wherein patients are treated through the employment of both catheters and small instrumentation using minimally invasive incisions.  Procedures are performed without the need for general anesthesia.  Radiology equipment, such as ultrasound imagery, are used to guide instruments throughout the procedure.  In some cases, interventional radiology is considered as an alternative to conventional surgery, and in scientific journals is viewed to be integral to the "operating room of the future."

Interventional Radiology Services at Geneva General Hospital
Typical interventional radiology procedures performed at Geneva General Hospital include arteriograms of various parts of the body, tube placements, and the insertion of catheter lines and vascular devices.  Tissue biopsies, venous sampling, angiography and angioplasty, embolization and various ablations are also performed in the health system's interventional radiology suite.

TIPS (Transjugular Intrahepatic Portalcaval Shunt) Procedure
Blood flows to our livers via the portal vein and is ultimately is returned from the liver to the heart via the hepatic vein.  Portal hypertension is a condition wherein the blood pressure within the liver itself becomes elevated.  This condition can be exacerbated by cirrhosis of the liver, but can result from other causes.  Portal hypertension becomes dangerous when blood flow is diverted around the liver and forms varicose veins in that vicinity of the body.  These varicose veins, though similar to those found in legs, may rupture internally.   Various treatment options are available, including the use of drugs, however, one of the most promising treatments is a procedure commonly known as TIPS, which is short for Transjugular Intrahepatic Portalcaval Shunt, especially where medical management may not be wholly effective.

Under relaxing sedation, a patient receives a catheter in their jugular vein through a small incision in the neck.  This catheter weaves its way through the circulatory system until it reaches the hepatic vein.  It crosses over a small synapse between the hepatic vein and the portal vein.  All of this is closely monitored using radiology equipment and intravenous dye.  Tubing in the form of stents is inserted, connecting the hepatic and portal veins, allowing blood flow from the portal vein to the hepatic vein.  From the hepatic vein, blood flow is conducted back to the heart via the vena cava.

Ordinarily, an overnight admission is required by the patient, allowing for close monitoring of your blood pressure.  The procedure is performed by a trained interventional radiologist, and it usually can be completed in under two hours.  The stents are intended to be in place for a lifetime, and they will be monitored by scheduled ultrasound exams.

A TIPS procedure is an alternative to abdominal surgery to correct the varicose conditions around the liver.  It is highly effective with minimal complications.  Typical side effects include stiffness or bruising in the neck and fever.  In a few instances, infection or abdominal bleeding has occurred.  A full guideline for the TIPS procedure and its use in management of portal hypertension can be found at http://www.guideline.gov/.

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