For patients

IRs are experts in the treatment of abnormal blood vessel development. In the womb, sometimes arteries and veins connect to one another in an abnormal fashion resulting in abnormal blood flow, associated pain and sometimes other symptoms. These malformations can be physically debilitating or psychologically damaging to a child’s development.

Using their expertise in performing embolization, sclerotherapy and/or laser treatments, IRs help address the associated symptoms of these malformations and, in some cases, help children feel better about their appearance. Sclerotherapy is a fancy word for any treatment designed to decrease the size and activity in a vascular malformation by causing the malformation to undergo a scarring process that over time decreases its size.

An example is treatment applied arteriovenous malformations (AVMs) and telangiectasias caused by conditions such as hereditary hemorrhagic telangiectasia (HHT), an inherited vascular disorder.

Blood clots in the pelvis and legs can be fatal. Interventional radiologists use medications and devices to help break up blood clots and open blood vessels that have been closed by clots, which can help reduce long-term damage from them.

An interventional radiologist can safely insert a small tube (catheter) directly into the stomach or small intestine of children under intravenous sedation or general anesthesia. This tube helps children who are unable to take sufficient food by mouth. In short-term situations, the IR may insert the tubes via the nose or mouth.

A biliary-enteric stricture is a narrowing or blockage of the passages in the liver that drains digestive chemicals (bile) from the liver into the small intestine, which can sometimes occur in children who have undergone liver transplantation. If that happens, a pediatric IR uses a special catheter with a balloon attached to the end of it to open the bile passages thus unblocking the backed-up fluid in the liver passage.

To do so, an interventional radiologist passes a needle through the skin and into the liver, using ultrasound and X-ray for guidance. Once there, the doctor uses a liquid agent that shows up on X-ray, called contrast, to watch the flow of the digestive chemicals, or bile, through the liver passage and identify the narrowed part of the passage. The congestion in the liver is relieved by opening the blocked area with the specialized balloon catheter or other specialized tools

A thin plastic tube (catheter) is safely inserted into a vein, so that fluid, nutrition, medication or chemotherapy can be injected into the bloodstream. Central venous access catheters reduce the need for repeated needle sticks for blood removal and drug injections. The types of catheters that may be placed include peripheral catheters in the arms (peripherally inserted central catheters, or “PICC lines”) or catheters in the neck or leg called “central lines.” A port, a small, specialized catheter device used to make repeated venous injections easier and less painful, is usually placed in the chest area, though in younger children it may be placed in the abdomen. The insertion will require at least some type of sedation or anesthesia in most children.

In a biopsy, an IR takes small samples of tumors in organs (e.g., liver or kidney) or other non-tumor lesions to determine whether the tumor or lesion will require further treatment or can be left alone (benign). The biopsy itself is performed with only a needle, via a small nick in the skin no bigger than a small freckle, using anesthesia to make the patient comfortable. An IR will use ultrasound, fluoroscopy and/or CT to help guide the needle through your child’s skin and into the tumor to take the sample.

A small plastic tube (catheter) is placed into an artery, injecting a liquid material that shows up on X-ray, called contrast, while X-rays are taken of the area. This kind of imaging helps diagnose vascular problems anywhere in the body, blood vessel malformations, high blood pressure, liver disease or other conditions.