Serving the community since 1947

Special Services

Interventional Radiology
Percutaneous Vertebroplasty
Uterine Fibroid Embolization (UFE)
Lung Cancer Screening
Cardiac Scoring
Vascular Ultrasound
Central Venous Access Placement
PET/CT Imaging
Exam Preparations

Interventional Radiology

Interventional Radiology (IR) is a medical specialty that uses radiologic images to guide thin tubes (catheters) and other tiny instruments through blood vessels and other pathways of the body to treat a wide variety of conditions that once required surgery.

IR procedures are performed by Interventional Radiologists who are physicians that have many additional years of special training after medical school. These physicians undergo extensive training in techniques that treat diseases percutaneously (through the skin) and other imaging techniques that see inside the body without surgery.

The interventional radiologists at Reno Radiological Associates are all board certified and hold a certificate of added qualification in Vascular and Interventional Radiology.

The advantage of IR is that risk, pain and recovery time are significantly reduced in many cases. Many procedures are performed on an outpatient basis, meaning no overnight stay in a hospital. General anesthesia usually is not required and procedures are often less expensive than the surgical alternative.

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Percutaneous Vertebroplasty

Do you suffer from back pain due to thoracic and lumbar compression fractures? If so, a new and innovative procedure is being performed at Renown Regional Medical Center, Inpatient Radiology department that offers significant relief. The procedure is called Percutaneous Vertebroplasty and for most patients who undergo percutaneous methacrylate vertebroplasty they notice significant improvement in pain within minutes or hours of the procedure.

The procedure is appropriate for osteoporotic or pathologic compression fractures between T4 and the sacrum, where at least some height of the vertebral body (usually at least at 30%) remains. Patients who meet these criteria and have not experienced significant improvement in either pain or mobility after two weeks of conventional therapy should be considered for the procedure. Ideally, we should treat the vertebral body before severe collapse occurs in order to minimize the kyphotic deformity and to facilitate the technical success of the procedure. For lesions above the T4 level, methacrylate vertebroplasty can still be performed, but is technically more demanding and the risks are slightly higher. For patients with multiple fractures, treatment of more than one level can occur in a single session

With the patient under intravenous conscious sedation and lying in the prone position, the procedure involves the placement of a needle into the affected vertebra and injecting bone cement into the damaged area. The flow of cement is carefully monitored with either bi-plane fluoroscopy or CT scanning. The procedure is performed on an outpatient basis via the Same Day Surgery (SDS) department at Renown Regional Medical Center. Typically, the procedure lasts one hour with an expected recovery time of 3 hours in SDS. No additional restrictions are placed on the patient after discharge except that vigorous activity should be avoided in the periprocedural period.

Patient selection is of the utmost importance, and appropriate clinical history and physician examination as well as localized radiographic findings are essential to the success of the procedure. In addition to standard radiographs of the spine, an MRI of the spine will be required prior to exam scheduling to rule out associated spinal stenosis or cord compression. This treatment should not be utilized, nor be expected to be effective for the treatment of degenerative disc disease, disc herniation, spinal cord or nerve root compression, spondyloysis, degenerative facet arthropathy, or spinal instability.

Prior to the procedure being performed, a vertebral fracture therapy consult and exam under fluoroscopy will need to be scheduled with the radiologist.

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Uterine Fibroid Embolization (UFE)

Fibroids are benign growths that develop in the muscular wall of the uterus. Fibroids do not always cause symptoms, but their size and location can lead to problems such as pain, heavy bleeding and anemia. Fibroids grow in size due to a large supply of blood. If the blood supply is stopped fibroids will shrink or go away. Embolization means the stopping or blocking of the blood flow. Uterine Fibroid Embolization is a way to stop the blood flow to the fibroid. The procedure can benefit women with several fibroids as well.

UFE is not a surgical procedure, but it is performed in a hospital. Most women receive some type of sedation prior to the procedure. The procedure is performed by an Interventional Radiologist (IR) using fluoroscopy to help guide a catheter the size of an uncooked spaghetti noodle to the fibroid. The catheter enters the body via a small nick made in the groin area and is passed through an artery to the uterus. Once the catheter is in place, the Radiologist will inject tiny plastic particles, the size of sugar granules into the catheter to the arteries that supply blood to the fibroid. The blood flow will decrease and the fibroid will eventually shrink.

The advantages to UFE versus Hysterectomy are a night stay in the hospital, shorter recovery period which allows you to get back to your life quicker, no significant blood loss, no general anesthesia and no big surgical incision. With every procedure there are side effects and UFE is no different. Some women experience moderate to severe cramps after the procedure, nausea and fever, infection which can be treated with antibiotics, injury to the uterus and early onset of menopause. Your radiologist will discuss these possible complications with you at your initial consultation

To know if this procedure is right for you, talk with your doctor, gynecologist and interventional radiologist. And, even though interventional radiologists have been performing embolizations for more than 20 years, some insurance companies may not cover the procedure. So, talk with your insurance carrier as well.

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Lung Cancer Screening

Management of lung cancer depends upon many factors, the most important of which is nodule size. Low dose CT screening for lung cancer detection has been shown to be highly sensitive for detection of pulmonary nodules. The stage of detection is considerably earlier with CT than detection by chest radiograph or symptoms. To be eligible a person must be at least 40 years old and have at least a 10 pack-year smoking history. The scan takes less than fifteen minutes and does not require a contrast injection. Further evaluation with a complete chest CT or PET scan is often done. We offer lung cancer screening at several of our outpatient locations.

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Cardiac Scoring

The primary role of CT in coronary calcification is the screening of asymptomatic individuals. The goal is early detection of non-occlusive coronary atherosclerosis so early modification of risk factors can be undertaken by the primary care physician or cardiologist. The candidate should be between the ages of forty and seventy and have at least one cardiovascular risk factor. Additional applications for this technology as described in the cardiology literature include evaluation of dilated cardiomyopathy and atypical chest pain in the elderly.

A "calcium score" is generated which roughly parallels the person's risk for symptomatic coronary artery disease. The score, likelihood of stenosis, and general recommendations are reported and based upon American Heart Association guidelines. The scan takes less than fifteen minutes and does not require a contrast injection. This scan is currently being performed at Renown Health X-ray & Imaging at 75 Pringle.

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Vascular Ultrasound

Carotid Duplex – non-invasive and accurate screening test for patients with history of TIA, Stroke or Carotid Bruit
Extremity Arterial Duplex – highly accurate and cost effective screening tool for diagnosis and characterization of lower limb arterial disease. This study can provide specific information about the location and extent of arterial stenosis and occlusion.
Extremity Venous Duplex – accurate non-invasive test for detection of Deep Venous Thrombosis. Follow-up of response to treatment of patients with DVT can also be performed. Occlusive thrombus can be differentiated from non-occlusive thrombus.
Renal Artery Duplex – non-invasive test for detection of Renal Artery Stenosis, the most common cause of Renovascular Hypertension. Direct imaging of the renal arteries is performed as well as analysis of intrarenal wave forms.
Mesenteric Artery Duplex – screening test for patients with Intestinal Angina suspected of having Atherosclerotic Disease of mesenteric vasculature. Color duplex imaging of the celiac and superior mesenteric arteries is performed.

We offer vascular ultrasound procedures at several of our outpatient locations. For more information on availability, please visit Renown Health's website.

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Central Venous Access Placement

Central venous access is an integral component in the care of patients with malignancies, infections and chronic diseases. Image-guided placement of central venous access catheters has been proven very safe and effective in providing access to the central venous circulation. The indications for placement of Central Venous Catheters have expanded considerably in recent years. An important aspect of this procedure is the need for outpatient rather than inpatient treatment of certain conditions. This requires devices that are relatively free of complication during their use long-term.

We are performing such services on an outpatient basis at Renown Regional Medical Center under both ultrasonic and fluoroscopic guidance utilizing Port-a-Catheters, Hickman Catheters and Groshong Catheters. The Radiologist is assisted by the radiology nurse to keep the patient comfortable during the procedure, which lasts approximately 45 minutes.

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PET/CT Imaging

PET/CT Imaging utilizes radioactive glucose in a variety of clinical settings including evaluation of pulmonary nodules as well as staging of non-small cell lung carcinoma, lymphoma and melanoma. Evaluation for recurrence of colorectal carcinoma is also an indication for PET/CT Imaging.

We offer PET/CT Imaging at Renown Health X-ray & Imaging at 75 Kirman.

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Exam Preparations

Many invasive procedures will require a patient to discontinue specific medications prior to their scheduled procedure. As a patient scheduled for such a procedure you should always check with the radiology department where your procedure is scheduled for specific instructions regarding current medications.

For more details on the exams listed above, please refer to websites such as www.scvir.org and www.snm.org.

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