1. I NTERVENTIONAL R ADIOLOGY Image Guided Therapy IR

2. W HAT IS I NTERVENTIONAL R ADIOLOGY ? Minimally invasive procedures for both diagnostic and therapeutic treatment purposes Performed by specially trained radiologists and staff Performed by using state-of-the-art imaging guidance Typically access structures through a tiny nick in the skin to perform a variety of procedures

3. T HE B ENEFIT OF I NTERVENTIONAL R ADIOLOGY Our procedures can help reduce or replace certain surgeries Faster recuperation than with surgery Usually no hospital admission required(done as outpatient) Less invasive-reduced to small punctures vs. large incisions Safe and effective

4. W HAT K IND OF P ROCEDURES DO W E DO ? In Interventional we will see a variety of procedures Biopsies Diagnostic and treatment of vascular problems Diagnosis and treatment of bone tumors Drainage of fluid collections Abscesses, chest and peritoneal collections, bile ducts/gallbladder, kidneys Insertion of feeding tubes Joint injections and aspirations Line placements:dialysis caths, ports, piccs, CVLs Lumbar punctures Treatment of Lymphatic and Vascular Malformations

5. P ROCEDURES AT A G LANCE Angiograms: Catheters in Groin Feeding Tubes Central Lines Lumbar punctures Joint Injections

6. D O WE ONLY USE X - RAY TO IMAGE ? NO! In Interventional Radiology we can use a multitude of means to achieve our goal. The C-Arm(Fluoroscopy=live-time) CAT Scan capabilities 3-D capabilities Ultrasound Guidance In most cases we will use 2 or more modalities together for most efficient use.

7. W HO DOES IT TAKE TO SUCCESSFULLY AND SAFELY PERFORM AN IR PROCEDURE ? It takes a multitude of modalities to work together to perform the best for our patients. Interventional Radiologist TechnologistsNursesAnesthesiologist Scheduling Staff

8. I S THE PATIENT COMFORTABLE ? We do what we can to make the patient pain free It all depends on what type of procedure we are performing The patient may need minimal sedation, general anesthesia, or nothing but reassurance or to watch a movie

9. W HAT WE NEED OF THE PATIENT TO SCHEDULE. Order from physician: Verbal, written or faxed Reason for exam Allery verification Parental consent Written or phone(with 2 witnesses) NPO Follow NPO guidelines of the hospital for specific needs Is patient being sedated or General Anesthesia Is this for GI procedure Patient is still instructed to take necessary medications on the day of procedure with exception of anticoagulants Check with Radiologist to determine post-procedure planning

10. W HERE DOES THE PATIENT START AND FINISH ? Some things to think about when scheduling is where does the patient check in? There are 3 points of entry. OP check in: No sedation necessary DS check in: Sedation or General Anesthesia Inpatient: Can be either no sedation, sedation or GA Always check with Radiologist for post-procedure plans Pt may be discharged immediately if no sedation needed Pt may go back to Day Surgery for recovery and discharge Pt may go back to Day Surgery then to admit Pt may go direct admit from recovery room

11. D ISCHARGE The Radiologist will present a discharge plan to include Post procedure instructions Activity instructions-school/gym excuse Aides ie: crutches, compression Pain Control Prescriptions vs otc Time frame for Follow up appointment Phone numbers to be supplied for any questions

12. R ESOURCES http://www.sirweb.org/patients/minimally-invasive- treatments/http://www.sirweb.org/patients/minimally-invasive- treatments/ http://www.chw.org/display/PPF/DocID/21522/router.asp http://eradiology.bidmc.harvard.edu/LearningLab/cardio/Qudsi.pd f http://www.radiologyinfo.org/en/sitemap/category.cfm?category=ir