There are many modalities in radiology, such as magnetic resonance imaging (MRI), computed tomography (CT), radiography, fluoroscopy, ultrasound, interventional radiography (IR), and nuclear medicine. Each modality has its own radiology technician that assists with running the exam. Each technologist is specifically trained in his or her modality. Interventional radiology is part of the operating room. Interventional technologists, or IR technologists, assist the doctors in the operating room. IR technologists have an important role in the patient’s experience by greeting the patient and staying with the patient until the operation is completed.
Other responsibilities include preparing the room, handling sterile equipment, and at times helping with the operating procedures. IR technologists are required to practice all the necessary sterile room procedures, such as wearing gowns, gloves, masks, and maintaining appropriate hand hygiene. Some of the procedures that an IR technologist performs are PICC lines, drainage tubes, biopsies, and angiography. The equipment used in most procedures is a C-Arm, which is their main source of X-rays. The C-Arm creates a low-pulse X-ray that allows them to see images in real time. IR technologists can operate ultrasonic machines that they normally use for biopsies or allow them to obtain vein or artery access.
Interventional radiology involves minimally invasive surgeries with lower risk and less pain in comparison to undergoing major, life-changing operations. Originally, IR was a subspecialty of radiology and was officially recognized as its own specialty by the American Board of Medical Specialties in 2012. Procedures that are minimally invasive are performed using image guidance. These procedures are similar to those in surgery but don’t require large entry incisions. In most procedures in IR, needles are inserted into the skin to access a vein or artery. Specialized catheters are guided through the blood vessels to locate the area of interest, and the appropriate treatment is given.
For example, cases that involve blood clots can be treated this way by having a small incision made, and the patient is able to go home with a Band-Aid covering the entry site. Some devices used in IR include stents, wires, balloons, grafts, and thrombectomy devices. These devices can be used to open constricted or blocked vessels. Biopsy devices can be used to take samples of potential tumors. Embolic materials such as coils, plugs, and beads can be used to block blood flow in cases of bleeding. Some beads can be blended with radioactive material or chemotherapy drugs to treat cancer.
Most patients treated in IR have incisions of only a few millimeters in length, in contrast to the traditionally larger incisions made in surgical procedures. This is beneficial because infection and bleeding risks are lessened. Local anesthetic and mild sedation also impede the complications of general anesthesia. This improves the outcomes of patients and decreases the length of hospital visits. Patients with more compromised immune systems who cannot endure traditional surgeries can more safely tolerate IR procedures.
IR is responsible for procedures involving essentially every organ in the body. IR in particular has cases on the vascular system, such as placing filters that prevent clots from reaching the lungs, treating malformations of the vascular system, and curing aneurisms of the aorta. In the gastrointestinal system, IR can remove gallstones and treat bleeds. In terms of the neurological system, IR can treat strokes, brain aneurisms, and fractures of the spine. IR can also treat cancer by freezing or burning tumors or injecting radioactive materials that can destroy the tumors. Lastly, IR can treat uterine fibroids or enlarged prostate glands.
A major area of the body where IR does procedures is in the blood vessels. These vascular procedures include the placement of inferior vena cava, or IVC, filters, which act to prevent blood clots from the legs from entering the heart and lungs. IR also helps treat vascular malformations in children. Abnormalities in the aorta, the artery coming from the heart and delivering blood to the body, can be treated by IR. Lastly, diseases of the veins, such as varicose veins, can be treated with IR techniques.
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