We use imaging tools to see your blood vessels. The tools we use include:

• Ultrasounds: These use sound waves to see inside the body. Doppler ultrasounds can detect blood flow.
• X-rays: They use radiation to see inside the body. Computer programs can combine X-rays to create cross-sectional images, called CT scans. When combined with dyes and computers, X-rays can create a real-time view inside the body, called fluoroscopy.
• Magnetic resonance imaging (MRI): Uses magnetic fields instead of radiation to see inside the body.

Some reasons your care team may ask you to have imaging of your veins or arteries include:

• If you have certain risks for blood vessel diseases
• If you’re having chest or abdominal pain
• Leg pain and swelling (signs of a blood clot)
• Lymphedema or swelling of the lymphatic vessels
• Checking the vessels after a heart attack, stroke or burst aneurysm
• Emergency care for heart attack, stroke or internal bleeding

Screening can find blood vessel issues before they have symptoms. It can identify who needs early treatment, saving lives.

Screenings your care team may suggest include:

• Aortic aneurysm screening: We use an ultrasound to check a large artery in your abdomen. Men should get screened once between the ages of 65 and 75 if they have ever smoked.
• Coronary calcium scan: A CT scan measures calcium in the walls of arteries leading to your heart. Buildup can lead to coronary artery disease. We use the scan to rate your risk for a heart attack. We can take action to clear the buildup if you’re at high risk.

Many of your blood vessels are very small. To see them well enough to test their function, you need to use several imaging tools.

We use some unique imaging tests to see blood vessels:

• Intravascular ultrasound uses a tiny probe inside the vessel for detailed internal views.
• Angiography uses contrast dyes and imaging to see inside blood vessels and organs. MR angiography uses MRI. CT angiography uses CT scanning.
• Fluoroscopy uses real-time X-ray imaging to view blood vessels. It’s called an angiogram when viewing arteries, or a venogram when examining veins.
• An arteriogram uses fluoroscopy and a catheter, a thin, flexible tube, to inject dye into an artery in your groin. The dye lets us see the vessels in real-time.
• Optical coherence tomography uses light waves to take high-resolution images inside blood vessels, mainly in the heart.

Interventional radiology combines imaging tools and minimally invasive surgical tools. There is a wide range of procedures for the arteries and veins.

Treatments for bleeding and aneurysms

If you’re bleeding internally, we can use imaging to locate the source of the blood and block it off, a procedure called embolization. Embolization can also block off blood flow to an aneurysm. Aneurysms are bulges in the walls of your blood vessels that can burst without warning.

We use image guidance to place items to block blood flow:

• Coils: Tiny metal spirals to block vessels
• Particles: Small beads that lodge in vessels
• Liquids: Glues or gels that harden to block vessels
• Plugs: Devices to close off larger vessels

We can use embolization to shrink fibroids, block blood flow to tumors, treat an enlarged prostate or stop bleeding in other areas of the body. It can even prevent excessive bleeding by blocking blood vessels before surgery.

Treatments to open narrow or blocked blood vessels

When a blood vessel is narrowed or blocked, areas of the body aren’t getting the oxygen they need. We use image-guided procedures to open these vessels and relieve symptoms. Often, we place small mesh tubes called stents to keep the vessels open.

Angioplasty widens blocked or narrowed arteries to improve blood flow.

• A coronary angioplasty uses a tiny balloon to push open the narrowed arteries in the heart. A stent can keep it open.
• Angioplasty can treat peripheral artery disease when the vessels supplying blood to the legs and feet are too narrow.
• We also use it for carotid artery stenosis—a narrowing of the large arteries on either side of your neck.
• Renal artery stenting can treat renal artery stenosis, narrowed or blocked arteries that supply blood to your kidneys.

Directional coronary atherectomy is a type of interventional heart procedure. We cut out a blockage in the coronary arteries using tiny wires and tubes.

We use radiation therapy (brachytherapy) when an artery with a stent narrows again and again. When other treatments fail to keep the artery open, we can use imaging to guide a catheter with radiation to open the narrowed artery.

To treat blood clots in the veins

Blood clots can develop when blood flow slows in the veins. The most common source is deep vein thrombosis. The blood clot forms in deep veins, often in the lower leg, thigh, or pelvis.

If they travel to the heart, brain, or lungs, they can stop blood flow. Blood clots can cause a stroke in the brain, a heart attack, or, if they travel to the lungs and block blood flow, a pulmonary embolism.

We use image-guided and interventional radiology procedures to help block and remove these blood clots.

• Catheter-directed thrombolysis: We use imaging to guide a catheter and deliver medicine to break up blood clots. We can also remove them from the veins.
• Deep vein recanalization: We use imaging to guide the placement of catheters, wires, stents or balloons to open up veins.
• Inferior vena cava filter: We use imaging to help place a filter into the large vein in your abdomen. The vein returns blood from the lower half of your body to your heart. The filter keeps large blood clots from the lower body from reaching your lungs.

Like we treat an aneurysm, we also use embolization to treat pulmonary arteriovenous malformations. This rare lung condition results in veins that connect directly to arteries in the lungs, bypassing the capillaries. Clots can form there, raising your risk of stroke and heart attack. The embolization cuts off this shortcut with coils or a balloon.

Access procedures

When you may need regular IV-based treatments, like cancer medicines or dialysis, you may need a venous access device. These are long-term IVs, including chest ports, peripherally inserted central catheter lines, and central venous catheters. We use imaging guidance to ensure proper placement. 

Interventional radiology procedures use imaging and tiny tools. These procedures are minimally invasive. Each procedure is slightly different. We will review the benefits and risks of any radiology treatment you may need.

Before

You may need to stop eating and drinking for several hours. Your care team will review your medical history, medications, and allergies (especially to contrast dye).

You’ll change into a gown, and the care team will place an IV line for medicine and fluids. You’ll speak with your doctor about the procedure and get to ask any questions.

During

You’ll lie on a table in a special procedure room. You may get light sedation to calm your nerves or conscious sedation to make you very relaxed.

During the procedure, your doctor uses imaging to guide a thin catheter through a small pinhole in your skin. They usually enter a vein through your groin, arm, or neck.

They find the blood vessel that needs treatment. Depending on your condition, the doctor may:

• Inject contrast dye to take pictures of the vessels (angiography)
• Open a blockage with a balloon or stent (angioplasty)
• Deliver medication to dissolve a clot (thrombolysis)
• Plug a bleeding vessel with tiny coils or particles (embolization)

Most procedures take 1 to 3 hours.

After

You’ll rest in a recovery area while the care team monitors your vitals. If we entered the vessel through your groin, you may need to lie flat for a few hours.

Depending on the procedure, most patients go home the same day or after an overnight stay. You might feel some soreness or bruising where the catheter went in. You’ll need to take it easy for a day or 2. Drink plenty of fluids if your procedure used contrast dye.

Keep the access site clean and dry, and watch for swelling, bleeding, or signs of infection. Follow your doctor’s instructions about activity and medications.