What is Interventional Radiology?

Interventional radiology (IR) treats many diseases through a needle puncture or a tiny incision, using imaging to guide the doctor precisely to the problem — often instead of open surgery.

How does it work?

Interventional radiologists are doctors specialised in radiology who have additional training in image-guided treatment. Using X-ray fluoroscopy, ultrasound, CT or MRI, they guide very thin instruments — needles, wires and catheters — through the skin or through the blood vessels to the exact place that needs treatment. There they can, for example, open a narrowed artery, block a bleeding vessel, destroy a tumour, drain an infection or take a tissue sample.

What can be treated?

• Blood vessels — narrowed or blocked arteries of the legs, aneurysms, bleeding, varicose veins and venous problems.
• Cancer — destruction of tumours by heat or cold (ablation), treatments delivered directly into a tumour's blood supply (embolisation, chemo- or radioembolisation), biopsies and ports for chemotherapy.
• Benign conditions — uterine fibroids, enlarged prostate, haemorrhoids, varicoceles and some thyroid nodules.
• Drainage and access — drainage of abscesses, bile ducts or kidneys, and placement of feeding tubes or long-term venous catheters.
• Pain and spine — targeted injections and treatment of some vertebral fractures.

See Treatments for a description of the main procedures.

What are the benefits?

• No large incision: usually only a small puncture in the skin.
• Most procedures are performed under local anaesthesia, sometimes with sedation.
• Less pain and a shorter hospital stay; many treatments are done as day cases.
• A faster return to normal activities.
• An option for some patients for whom surgery would be too risky.

Is it safe?

Image-guided procedures generally have a low rate of complications, but like any medical treatment they are not risk-free. Possible risks — such as bleeding or bruising at the puncture site, infection, or a reaction to the contrast medium — depend on the procedure and on your health. Your interventional radiologist will explain the expected benefits, the risks and the alternatives before asking for your consent.

Before your procedure

You are usually referred by your family doctor or a specialist, and your case may be discussed in a multidisciplinary meeting. It helps to prepare a few questions:

• Why is this procedure recommended for me, and what are the alternatives?
• What are the expected results and the possible risks?
• How should I prepare — fasting, blood tests, my usual medication (especially blood thinners)?
• Will I need to stay in hospital, and when can I go back to work or drive?
• Who will follow me up afterwards?

Always tell the team about allergies (in particular to contrast media), blood-thinning medication, kidney problems or a possible pregnancy.

Is it covered by health insurance?

Coverage varies depending on the procedure, the indication and your insurance. Ask your doctor or your health insurer before the procedure if you are unsure.