Interventional radiology (IR) enables us to perform minimally invasive procedures by using X-rays to see inside your child’s body during the procedure. Our highly advanced interventional suite offers low-dose technology to keep your child’s exposure to radiation to an absolute minimum.
Our Staff and Facility
The IR team at Riley Hospital for Children Radiology at Indiana University Health includes Indiana’s only pediatric-trained interventional radiologist. Our specialist leads a team of IR technologists, nurses and a physician assistant trained especially for work with children.
We have many years of clinical and research experience, so we can provide your child with appropriate care and the most advanced procedures available. We provide an environment suited specifically to your child’s condition and emotional needs because we understand the special needs of children.
Our complete IR suites are fully contained within Riley Radiology at IU Health. All preparation, procedure and recovery rooms are together in one location. In addition to our pre- and post-procedure rooms, the suite has an anesthesia induction room and a family consultation area. Our fully digital picture archiving and communication system (PACS) workstation allows us to read exams and consult with referring physicians.
Procedures Performed by Interventional Radiology
Interventional radiology can replace some diagnostic and treatment surgeries with minimally invasive procedures done using image guidance. We use special tools and materials in smaller sizes and lengths, made especially for children.
Sometimes interventional procedures can cause pain. We control pain with conscious sedation and general anesthesia. We also use trained Child Life specialists to provide distraction during minimally painful procedures.
Most of our procedures use live imaging (live pictures of the inside of the body) to guide instruments inside the body. Use of imaging enables great precision and allows us to reduce or eliminate the need for surgery in some cases.
Procedures we perform include:
- Renal vascular disease. Renal artery angioplasty and stenting. Angioplasty and stenting (placement of plastic or wire mesh tubes) expands blood vessels around the kidneys and places small supports inside to hold them open.
- Visceral angiography. We view the arteries supplying the intestines using small amounts of harmless dye and X-rays.
- Biliary Intervention
- Biliary drainage (native and transplant liver). We insert a tube to drain the bile duct.
- Cholecystostomy: In this procedure we insert a tube to drain the gall bladder.
- Biliary endoscopic laser lithotripsy (BELL) and percutaneous stone retrieval. These procedures destroy or remove stones within the bowel ducts (these drain bile from the liver to the small intestines) through a small, precisely placed incision.
- Cancer Therapy
- Chemoembolization of liver tumors. We inject chemotherapy drugs directly into a tumor to block blood flow to the tumor.
- Radiofrequency ablation (RFA) of liver tumors, kidney tumors and osteoid osteomas. Electrical current applied directly to tumors kills them.
- Stenting of malignant strictures. Bile duct, esophageal, tracheobronchial and intestinal. By placing tubes in body passages obstructed by tumors we allow fluids and other substances to flow through those passages.
- Chronic Renal Failure/End Stage Renal Disease
- Dialysis access planning (ultrasound mapping and venography). This is how we determine the best blood vessel to be used for dialysis.
- Percutaneous treatment of malfunctioning or thrombosed dialysis access. We fix problems with the blood vessel being used for dialysis.
- Drain Insertion
- Paracentesis. Paracentesis drains fluid surrounding the abdominal organs.
- Thoracentesis. Similar to paracentesis, thoracentesis drains fluid surrounding the lungs.
- Percutaneous drainage of abscesses and fluid collections. We drain pus that is collecting in an inflamed area of the body.
- Placement of chest tubes. We insert a tube through the membrane surrounding the lungs to drain air or fluid from this area.
- Varicocele embolization. This procedure blocks damaged blood vessels in the scrotum to encourage blood flow through healthy blood vessels.
- GI bleeding. We can block damaged blood vessels to stop bleeding into the gastrointestinal tract.
- Arteriovenous malformations, peripheral and pulmonary. By blocking abnormal blood vessels in the limbs and lungs we encourage blood to flow through healthy blood vessels.
- Hemoptysis: bronchial artery embolization. Blocking damaged blood vessels stops bleeding into the lungs.
- Gastrointestinal Intervention
- Placement of gastrostomy and gastrojejunostomy feeding tubes. We allow nutrition to flow directly into the stomach or intestine by inserting tubes that lead outside the body.
- Placement of cecostomy tubes. This procedure inserts a tube into the cecum (part of the large intestine) for enema administration.
- Genitourinary Intervention
- Nephrostomy, nephroureterostomy and ureteronephrostomy. We place permanent or semi-permanent passages through the skin to drain urine.
- Uretheral stents. We insert small tubes to allow urine to flow freely from the kidneys to the bladder.
- Percutaneous access for stone retrieval. Through a small, precisely placed incision we can remove kidney stones.
- Suprapubic drainage. A small tube placed through the skin drains the bladder.
- Percutaneous Biopsy
- Image-guided soft tissue and bone biopsy. Using imaging we can guide instruments to take a tiny sample of tissue.
- Intraarticular steroid injections. We guide injection of steroid medication into a joint.
- Percutaneous liver and kidney biopsy. We can use imaging to guide a needle for taking a tiny sample of tissue.
- Transjugular liver biopsy. We guide a biopsy tool through veins to the liver to take a small sample of tissue.
- Portal Hypertension
- Transjugular intrahepatic portosystemic shunt (TIPS). By placing a metallic stent we allow blood to flow from the liver back to the heart.
- Variceal embolization. Blocking damaged blood vessels stops bleeding into the intestine.
- Venous malformations. By blocking malformed clusters of blood vessels we can reduce pain and swelling and encourage blood flow through nearby healthy vessels.
- Lymphatic malformations. Blocking malformed clusters of lymphatic ducts reduces swelling and pain.
- Venous Access (inserting lines into veins for specialized uses)
- Peripherally inserted central catheters (PICC). These tubes are used for such treatments as prolonged antibiotic infusion, chemotherapy and total parenteral nutrition.
- Chest ports. These are devices inserted near the top of the chest and used for such treatment as prolonged antibiotic use and chemotherapy.
- Apheresis, dialysis and infusion catheters. These catheters are used for longer term access to veins than an ordinary IV.
- Temporary central venous catheters. These tubes are similar to a chest port or PICC but are used for shorter periods of time.
- Venous Thromboembolic Disease
- Venous thrombolysis, angioplasty and stenting. These treatments destroy and prevent blood clots in blood vessels.
- Permanent and temporary caval filtration. These are devices that prevent blood clots from entering the lungs.