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If you're like many people, when you hear “radiology” you think “images.” But today’s specialists in vascular and interventional radiology (VIR) go beyond taking pictures of the body’s systems to treat illness in an efficient, minimally invasive way. And Westchester Medical Center has opened a state-of-the-art suite dedicated to this growing medical field.
“It’s an excellent facility, fantastically well built,” says Grigory Rozenblit, M.D., Director of Vascular and Interventional Radiology and Professor of Radiology and Surgery at New York Medical College.
The VIR facility reflects a major investment by Westchester Medical Center. “As the need for advanced care in the region grows, we must continue to expand our services and invest in new technology and new infrastructure,” says Anthony Costello, Senior Vice President for Professional and Support Services. “In recent years we’ve made a significant investment in all areas of the hospital, including the renovation and expansion of our Emergency Department and a complete renovation of the seventh floor. The new VIR suite speaks to our commitment to provide the latest minimally invasive treatments to our patients.”
The new suite brings together in a central facility related services that were once dispersed around the hospital, says Dr. Rozenblit. It also features newly acquired machinery that helps doctors performing very complex procedures using instruments guided by radiologic imaging. Typically, VIR procedures begin with a small opening in the skin about the size of a pencil’s graphite tip. Because the entry points are so tiny, this approach often carries a lower risk of bleeding or infection and enables a quicker recovery than in traditional surgery, and it may make a general anesthetic unnecessary.
One important tool in the new facility is an interventional angiography system that is capable of turning X-ray images into three-dimensional, volumetric pictures like those obtained in computed tomography (CT) scans. VIR physicians can use the system to help them guide catheters or other instruments through the vascular or biliary system, urinary tract or gastrointestinal tract accurately to the site of a problem, such as cancer.
“Say you’re treating a tumor in the liver,” says Dr. Rozenblit. “You want to navigate your catheter into the artery that leads only to this tumor so that you can inject a medication to treat the tumor. With an older machine you look at a flat image with limited perception of depth. This new machine allows precise threedimensional guidance of your catheter.”
Another new device actually takes images from different modalities—CT, magnetic resonance imaging (MRI) and ultrasound, for example—and “fuses” them together to pinpoint the location of a problem with the greatest possible accuracy. Then this device uses an electromagnetic field without X-rays to guide the instruments to the area of the problem. “This technology is very good for taking biopsy samples and treating tumors with microwave ablation,” he says. (The last phrase refers to the use of microwave radiation to burn tumor cells.) “It greatly improves precision and lets us use less radiation.”
Along with these treatments, VIR specialists can perform a full menu of other procedures. (See “All This and Imaging Too,” at right.) While no treatment is riskfree, the risks of VIR procedures can be far lower than the risks of open surgery, Dr. Rozenblit says. And many VIR treatments can be performed on an outpatient basis or with just a short hospital stay, so recovery time is significantly reduced and patients can return to normal function in days rather than weeks.
The new suite features an attractive waiting room. Each patient has complete privacy, and the procedure areas are equipped with a TV to watch before treatment or during recovery.
“We have the largest, most advanced vascular interventional radiology service in the Hudson Valley,” says Dr. Rozenblit. “Everyone on our team, including the nurses and technicians, is specially trained and works exclusively in interventional radiology. That’s something not every hospital can say.
ALL THIS AND IMAGING TOO
Here are some of the services provided by the Vascular and Interventional Radiology Suite at Westchester Medical Center today:
- uterine fibroid embolization, a nonoperative treatment for fibroids
- varicocele embolization, a nonoperative treatment of varicocele (an enlargement of veins in the scrotum)
- treatment of tumors by chemoembolization (injection of therapeutic agents directly into the blood vessel supplying the tumor) and by ablation (such as destroying the tumor with a microwave probe)
- complete hemodialysis access service, with declotting and repairing grafts of veins, in order to prolong the functional life of dialysis access lines
- placement of short- and long-term catheters and ports into the venous system, and maintenance therein, for injection of medications, intravascular nutrition and hemodialysis
- transjugular liver biopsy to decrease the risk of bleeding in patients with poor clotting
- needle biopsies of the neck, thyroid, chest, lungs, abdominal organs, bones and soft tissues
- vena cava filter placement (installation of a filter into major veins to prevent traveling of life-threatening blood clots to the lungs) and retrieval of the device when it is no longer needed
- “TIPS” shunting for treatment of patients with complications of chronic liver disease
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