Interventional Radiology Information for Physicians
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At Stanford Medicine, we carry the legacy of some of the leaders and innovators of Image guided intervention. The Stanford Interventional Team works closely with referring physicians from Stanford as well as surrounding community hospitals with an active outpatient Interventional Radiology Clinic, as well as an inpatient consultation service. OncologyWe provide comprehensive care for patients with cancer. Diagnostic interventions include fine needle and core biopsies under CT, MRI or ultrasound guidance Therapeutic interventions: Include state of the art treatment for primary and metastatic tumors involving the liver, lungs, kidneys and bone including chmoembolization and chemoinfusion, siraspheres, radiofrequency (RF) ablation and cryoablation. Stanford Hospital & Clinics has implemented a physician portal to allow both Stanford and referring physicians to access their patients' information from the Internet. |
Stanford Physician Portal
Supportive and Palliative Treatment
Patients with cancer often need palliative care to improve their quality of life. Primary tumors such as multiple myeloma and metastatic disease involving the spine are often extremely painful and debilitating due to compression and microfractures of the involved vertebral body. These painful fractures can be easily stabilized with minimally invasive percutaneous methods such as vertebroplasty and kyphoplasty. In addition to stabilization of the fracture, tumor involvement of the vertebral body can be treated with RF ablation.Besides the spine, tumor involvement of the other axial skeletal bones such as those of the pelvis can also be treated in a similar fashion, a procedure known as cementoplasty.Curative as well as palliative systemic therapy is often administered via peripheral veins. However, this often destroys peripheral veins and patients who need long-term chemotherapy may be candidates for chest ports or arm ports. These subcutaneous infusion ports can be easily placed under radiological guidance under conscious sedation.Patients presenting with refractory pleural effusions and/or ascites are often treated with frequent thoracentesis and paracentesis. In an effort to improve their quality of life, interventionalists can place short-term or long-term drainage catheters. Initial treatment for malignant pleural effusions includes placement of a small drainage catheter (8 Fr) followed by pluerodesis using a sclerosant agent such as Bleomycin. Patients who are unsuitable candidates for pleurodesis or fail pleurodesis can be treated with long-term outpatient drainage catheters known as Pleurex catheters. Refractory ascites can be treated with long-term Denver shunts (subcutaneous catheters that drain the peritoneal fluid into the right internal jugular vein). In addition to these palliative measures, we also provide other routine procedures such as gastrostomy tubes and gastro-jejunostomies.
Women's Health
The division of Interventional Radiology works in close association with Women's Health @ Stanford. 20 percent of women have uterine fibroids and can present with menorrhagia, pelvic heaviness and urinary frequency or urinary incontinence. Uterine fibroid embolization is a minimally invasive procedure offered as an alternative to surgical procedures such as hysterectomy and myomectomy.For post-menopausal women, osteoporosis can be crippling and limit their simple day-to-day activities such as walking and gardening. Severe back pain is often due to osteoporotic compression fractures. Traditionally treated with bed rest and pain medication, these fractures can now be easily treated with a minimally invasive procedure known as vertebroplasty or kyphoplasty. Both procedures are outpatient procedures and are done with minimal light sedation (conscious sedation).
Go Red!
Cardiovascular disease is the number one killer amongst women, claiming over 500,000 lives every year. Yet, many women still believe that cardiovascular disease is a disease of the opposite sex.
The American Heart Association (AHA) Go Red For Women movement raises awareness about cardiovascular disease amongst women and their loved ones, using the color Red not only as a symbol for women and heart disease, but also empowering women to invest time and energy into their and their families heart health.
DVT and May Thurner Disease
Deep venous thrombosis (DVT) remains the Achilles Heel of medicine. In the United states of America, over 600,000 people are diagnosed every year and over 200,000 people die from complications related to DVTs. In young women, without any known risk factors, DVT in the left leg is almost always due to May-Thurner syndrome. The right iliac artery crosses in front of the left iliac vein and can at times damage the endothelium of the left iliac vein causing a stenosis that often progresses to occlusion resulting in the classic May-Thurner syndrome. DVT in general and May-Thurner syndrome, if left untreated, can cause fatal complications or cause debilitating post-thrombotic syndrome characterized by severe leg swelling, discoloration, pain and rarely arterial obstruction. Acute and chronic DVT can be treated using minimally invasive techniques using lytic agents and various endovascular devices. Unlike DVT, varicose veins involve the superficial venous system. Varicose veins are seen more often in women, advancing age and after pregnancy. Similarly, spider veins or telangiectasia is seen more often in women and may be hereditary. Spider veins and varicose veins are sometimes cosmetic problems, however, with progression of disease, these can often present with pain, heaviness, burning symptoms and skin changes. Traditional ways of treating varicose veins involve surgery requiring general anesthesia. However, most varicose veins and spider veins can now be easily treated using minimally invasive techniques such as laser ablation, phlebectomy and sclerotherapy performed with a small amount of local anesthesia.
Bone Tumors and Compression Fractures
Vertebral compression fractures secondary to osteoporosis, multiple myeloma or metastatic disease can be crippling, limiting simple day-to-day activities such as walking and gardening. Traditionally treated with bed rest and pain medication, these fractures can now be easily stabilized and treated with minimally invasive procedures known as vertebroplasty or kyphoplasty. In addition to stabilization of the fracture, tumor involvement of the vertebral body can be treated with RF ablation. These procedures are outpatient procedures and are done with minimal light sedation (conscious sedation).Besides the spine, tumor involvement of the other axial skeletal bones such as those of the pelvis can also be treated in a similar fashion, a procedure known as cementoplasty.
Osteoid Osteoma and Painful Bone Lesions
Osteoid osteoma is a disease of the young characterized by extremely painful bony lesions, occasionally presenting with a pathological fracture. These are benign lesions diagnosed on Xrays or CT. Although, traditionally treated with surgical resection of the lesion, RF ablation is an alternative minimally invasive technique performed as an outpatient service with high success rates. Focal bony metastatic lesions can be treated in a similar fashion for pain palliation.
