Interventional Radiology Procedures at Main Line Health
(May 2005) — People suffering from varicose veins, compression fractures of the spine and uterine fibroids can find alternatives to traditional surgery with minimally invasive radiology procedures offered at the Main Line Hospitals of Bryn Mawr, Lankenau and Paoli.
"Using imaging guidance, such as X-ray, MRI, ultrasounds or CT-scans, we are able to treat these common conditions extremely effectively," said Eric Stein, M.D., interventional radiologist at Bryn Mawr Hospital and chief of the Interventional Radiology section.
Along with Stein, interventional radiologists Vikram Dravid, M.D., Atul Gupta, M.D., John Schilling, M.D., and Mark Scott, D.O., are practitioners of a growing subspecialty that brings together the use of advanced X-ray equipment and tiny instruments in new techniques.
Recently acquired by the Main Line Hospitals is the VNUS Closure® system for varicose veins, a painful and unattractive condition that causes bulging blood vessels in the legs. The condition affects 20 to 25 percent of women and 10 to 15 percent of men.
Rather than conventional vein stripping, the interventional radiologist guides a probe through a tiny catheter into the vein and then transmits radio frequency energy. The passage of heat through the vein wall as the catheter is withdrawn causes resistive heating, which shrinks the vessel.
"There is no incision, no real scarring, and most patients report an improvement in symptoms within one to two weeks following the procedure," said Stein. "Published data suggest the patients remain varicose-vein free after two years about 90 percent of the time."
Another condition treated using minimally invasive techniques is uterine fibroids. These benign growths in premenopausal women often lead to pelvic pain, heavy bleeding, frequent urination or abnormal enlargement of the lower abdomen. The traditional surgical approach has been to completely remove the uterus or spare the uterus by only removing the largest fibroid or collection of fibroids.
According to Stein, interventional radiologists perform uterine embolization using X-ray imaging to pass a tiny tube catheter into the artery that feeds the fibroid tumors and then inject tiny plastic particles to block the artery. "The fibroids are cut off from their blood supply and shrink, giving significant or total relief of symptoms to 83 to 90 percent of women," he explained. "We're able to perform this procedure with a local anesthetic and intravenous medication, without the need for general anesthesia. When we're done, the patient only needs to wear a Band-aid." The recovery time is usually one week to ten days, unlike hysterectomy, which requires about six weeks of down time for the patient.
Finally, compression fractures of the spine are being treated in about one hour through a procedure called vertebroplasty. Spinal fractures usually occur in women over the ages of 60 who suffer from osteoporosis. In vertebroplasty, the physician guides a needle into the crushed vertebrae and injects bone cement, stabilizing the fracture.
The technique only needs a local anesthetic and mild sedation. "Studies have shown that from 75 to 90 percent of people treated with vertebroplasty will have complete or significant reduction in their pain, usually within 48 hours. Many people can resume their normal daily activities immediately," said Stein.
While the uterine technique requires an overnight hospital stay, treatments for compression fractures of the spine and varicose veins are done on an outpatient basis.
"For the patient, these procedures are a safe and less expensive alternative to surgery and other treatments," concludes Stein. "As our imaging technology continues to improve our ability to see inside the body, we look forward to the development of more interventional radiology techniques to give patients more options in the future."
For more information, call 1.866.CALL.MLH.