Who are interventional radiologists?
First, let me explain who interventional radiologists are not: they are not surgeons, radiation oncologists, cardiologists, oncologists, gastroenterologists, internists, and so on. They are physicians, who, like other physicians, went through the rigorous paths of qualification to bear the “MD” appelation. They then went through additional residency training that required 1 year of internship in any core medical specialty followed by 4 years of radiology residency and, finally, elected to have more hands-on training or exposure in the specialty of interventional radiology from six months to 3 years. Some specialize in treating intracranial disorders and are called interventional neuroradiologists, while others treat extracranial diseases and are called body interventional radiologists. Some practise both.
Thus, not only are these physicians able to diagnose or forecast diseases from the shadows they cast on various imaging modalities (radiographs, CAT scans, ultrasonography, magnetic resonance imaging (MRI), nuclear scintigrams, etc), interventional radiologists perform a wide range of procedures with such instruments as catheters, guidewires and balloons using imaging guidance (x-rays (fluoroscopy), ultrasound, CAT scan, or MRI) and cause minimal body injury in the process. They open occluded arteries; remove foreign bodies from the body like those in blood vessels; drain fluid collections in the body; biopsy tumors for diagnosis; locally destroy cancers with heat, cold, chemicals or arterial embolization; remove blood clot from veins or prevent it from travelling from other sites to the lungs; provide patients with sophisticated accesses into their veins for hemodialysis, medications, fluids, and nutrition. The list is long and I have little space to recount it all, but more information is at www.medradclinics.com under “MRC’s services”.
In modern healthcare, whether you are a patient, a physician or an hospital administrator you are likely, sooner than later, to call in the services of an interventional radiologist much in the same way you would the services of any other specialist, though you may not know it. And there are reasons for this.
Most interventional radiological procedures do not need general anesthesia.
Because there is minimal invasion of the body during most interventional radiological procedures, patients do not require general anesthesia. Rather, they receive a calming tranquillizer and an opiate that blunts pain – sedoanalgesia. As a benefit sedoanalgesia induces amnesia for the procedure which is good in some patient populations such as children. Equally appealing is the fact that since patients can be treated without general anesthesia they do not have to undergo the rigorous medical scrutiny other patients undergo to qualify
for general anesthesia; their preoperative screening is less rigorous yet important. The need for general anesthesia in some patients may disqualify them for important procedures because they are considered operative risks. Thus, there have been situations when the auspicious recruitment of the skills of an interventional radiologist has saved an ischemic limb or arm, a segment of dying bowel, an overwhelming infection, or simply, an unnecessary surgeon’s scalpel.
Interventional radiological procedures are minimally invasive..
Not long ago if you had an abdominal aortic aneurysm that required treatment, you invariably needed a surgeon. If you were a surgeon caring for a patient who developed peritoneal abscess after laparatomy or as complication of appendiceal rupture you invariably would cut them open again. If you were an urologist
caring for a patient in whom you have difficulty retrogradely stenting their ureter per urethram, you were up a creek. If you were a woman with symptomatic uterine fibroids, you had to have hysterectomy or myomectomy. If you were a smoker with a mass in your lung, you needed a chest surgeon for excisional biopsy if the results of bronchoscopy were unhelpful. If you were a diabetic with a non-healing ulcer of your foot, you were unavoidably one step to being down by one limb. If you were an infertile couple your only hope was a gynecologist or an urologist. If you had troubling and disfiguring varicose veins in your limbs, you either ignored them or received a visit from a surgeon. Today, for each of these instances, there is a less invasive, equally effective and less costly alternative treatment that an interventional radiologist can offer.
Interventional radiological procedures translate into short hospital stay and less cost.
Since by their nature interventional radiological procedures inflict little or no physical and physiological trauma to patients, many of them can be same-day procedures. This means little or no contact with sicker patients and so less risk of hospital-acquired infection; quick recuperation and return to an active lifestyle; fewer complications due to sedentary recuperation that invasive procedures induce; and less lost income from sick days. It also means less hospital costs and lower health insurance premiums. So, it is a prudent
patient, physician or hospital administrator who actively seeks and promotes the services of an interventional radiologist in modern medical care.