Interventional Radiology

What is an Interventional Radiologist?
Interventional radiologists are medical doctors who are specialized in performing medical procedures that involve radiology, using guided imaging equipments such as X-rays, magnetic resonance (MR) imaging, ultrasound and computed tomography (CT) to diagnose diseases.

IRs are board certified radiologists that are fellowship trained in percutaneous interventions using guided imaging. Their specialized training is certified by the American Board of Medical Specialties.

Brief History: The improved ability to see inside the body with radiologic imaging and the development of tools such as balloon catheters, gave rise to interventional radiology (IR) in the mid-1970s. Interventional radiologists pioneered coronary angiography and other minimally invasive procedures that are commonplace in medicine today. In 1992, the American Medical Association officially recognized IR as a medical specialty, and today there are more than 5,000 interventional radiologists in the United States.

The Society of Interventional Radiology (SIR), the professional association of interventional radiologists based in Fairfax, Va., has seen its membership steadily increase to more than 3,600 worldwide in 2001.

What are the advantages of minimally invasive treatments?
  • Minimally invasive procedures are often less expensive than surgery or any other alternatives
  • General anesthesia is usually not required
  • Pain and recovery time are often significantly reduced
  • Most procedures can be performed on an outpatient basis or require only a short hospital stay
What is an Angiogram?
Angiography is an X-ray exam of the arteries and veins to diagnose blockages and other blood vessel problems.

Angiograms are performed by interventional radiologists (IR). During an angiogram, the doctor inserts a thin tube (catheter) into the artery through a small nick in the skin about the size of the tip of a pencil. A substance called a contrast agent (X-ray dye) is injected to make the blood vessels visible on the X-ray.

In many cases, a IR can treat a blocked blood vessel without surgery at the same time the angiogram is performed. Interventional radiologists treat blockages with techniques called angioplasty and thrombolysis.

What is Angioplasty and Stent?
Angioplasty is a way of opening a narrowed or closed blood vessel without having to do major surgery.

A catheter with a tiny balloon at its tip is inserted into the blood vessel; usually one of the coronary arteries supplying the heart wall or a major artery bringing blood to an arm or leg. After advancing the tip of the catheter to the site of blockage, the balloon is then inflated, deflated and removed.

The narrowing or blockage most often is caused by arteriosclerosis, or hardening of the arteries (fatty plaques form on the inner wall of the artery and become larger, gradually cutting down on free blood flow), expanding the balloon stretches the arterial wall and disrupts the fatty plaques, helping to restore blood flow.

Between 70 percent and 90 percent of the angioplasty procedures use a stent. Stent is a hollow thin-walled wire mesh tube which keeps the vessel open after widening it. Because arteriosclerosis is an ongoing disease, more plaque might form and again limit blood flow. The stent is placed onto the balloon and pressed firmly against the artery wall when inflating it. The balloon then is deflated, leaving the stent in place to act as a scaffold.

Occasionally the plaque will not remain against the inner lining of the artery but goes back to its former position after the balloon is deflated. Another possibility is that a small amount of plaque may continue to block the flow of blood. In these cases the radiologist may place a stent that is expanded at the site of plaque. The muscle tissue in the vessel wall holds the stent in place. In time, a layer of cells forms over the stent, which in effect becomes a part of the vessel. In some cases the size of the diseased artery and the site of blockage make a stent especially useful.

A stent also may be placed to keep an artery open if the inflated balloon has torn or damaged it. Some modern stents are covered with a drug that helps keep the artery open; they seem to improve the long-term success rate.

What are the health plans with which you participate?
For your convenience we have contracted to accept most insurances in Santa Clara County, but you should always directly verify coverage of procedures with your insurance provider.

Visit our Insurances page for more information.


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