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Interventional Radiology

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Interventional radiologists diagnose and treat conditions using imaging, such as ultrasound, CT (computed tomography) scan or fluoroscopy, to guide their work. They specialize in procedures to find and correct problems, often deep inside the body, without surgery. For many procedures interventional radiologists pass a thin tube (catheter) into a blood vessel through a tiny incision. They then thread the catheter through the network of vessels to reach the target area and inject dye. The dye shows up on an X-ray. Once a problem is found and diagnosed, they may treat it through a catheter-based or other treatment.

Seattle Children’s interventional radiologists have special pediatric training and use equipment and techniques designed for children and teens. We focus on your child’s safety and comfort and take great care. Our equipment uses the lowest amount of radiation possible. We can also use imaging tools that don’t involve radiation, such as intravascular ultrasound. (For more information, read our radiation exposure handout [PDF].) When needed, children receive general anesthesia so they don’t feel anything.

The interventional radiology team sees patients in clinic and works closely with specialists from many other areas of Seattle Children’s, including the Cancer and Blood Disorders Center, the Heart Center, Gastroenterology, General Surgery, Nephrology, Neurology, Neurosurgery, Orthopedics, Rheumatology and Vascular Anomalies.

Conditions We Treat


Our team is involved in care for children and teens with a wide range of conditions, including these.


Aneurysms

An aneurysm is a bubble-like wide spot in an artery. It usually develops due to a weakness in the wall of an artery. Doctors usually find an aneurysm when it breaks open and bleeds. Most of the time, aneurysms do not bleed until a person reaches middle age, but sometimes they can bleed in children. Read more.

Arteriovenous malformations

Arteriovenous malformations (AVMs) are tangles of small, abnormal arteries and veins that may occur in the brain or elsewhere in the body. They bleed easily without warning and for no obvious reason. This happens most often in adults from 20 to 40 years old, but sometimes in children. Read more.

Biliary or liver problems

Bile, a liquid made in the liver, helps the body digest fats. Bile flows through tiny ducts within the liver into larger ducts that lead to the gallbladder and intestine. Several problems with the bile ducts or liver can block bile flow.

Blood clots

Blood clots form as part of a healthy process to stop bleeding, and the body dissolves them over time. However, clots can be harmful, even deadly, if they block the flow of blood through a vessel, especially in the lungs, brain or heart. Read more.

Bone tumors

Tumors are lumps of tissue that form when cells divide uncontrollably. Most bone tumors are benign (not cancer) and do not spread from their original location, but some are cancerous and need treatment. Even a benign bone tumor can cause problems as it grows. Read more.

Cancer

Cancer cells divide uncontrollably and can invade nearby tissues and spread to cause tumors in other parts of the body. Most cancers are treated with chemotherapy, radiation therapy, surgery or a combination of these. For some cancers interventional radiologists can provide medicine or other treatment right to the site of a tumor. Read more.

Kidney failure

Kidney failure occurs when the kidneys no longer remove wastes from the blood or control salts in the body well enough to support life. Without dialysis (a process to clean the blood outside of the body using a machine) or a kidney transplant, fluid and waste products build up. Read more.

Venous malformations

Venous malformations (VMs) are collections of veins that are full of blood but are not used by the body. They grow slowly as your child grows. As your child gets closer to the pre-teen years, a VM may begin to cause pain and swell. Read more.

Services We Offer

Angiography

Doctors use this X-ray of the arteries (arteriography) or veins (venography) to check for and treat blood vessels that didn’t form properly or that are narrowed, blocked or enlarged. An interventional radiologist, guided by fluoroscopy, inserts a catheter into a blood vessel. They then thread it to the target area and inject dye before taking an X-ray. Treatment may include inserting a balloon or stent to open the blood vessel (angioplasty).

Dialysis access maintenance

To provide dialysis for a child with kidney failure, a surgeon must connect a child’s artery and vein. Several problems may decrease blood flow through this connection. An interventional radiologist, guided by fluoroscopy, can insert a catheter to open a narrowed area with a balloon or stent or can dissolve or break up a blood clot.

Embolization

Sometimes doctors may need to stop blood flow through an artery or vein. This may be when a child has a brain aneurysm, a vascular malformation or heavy bleeding from an injury. An interventional radiologist, guided by ultrasound and fluoroscopy, inserts a catheter into a blood vessel. They then thread it to the target area and inject a substance to block the flow through the area.

Radiofrequency ablation

Radiofrequency ablation uses heat to treat small tumors. This includes benign bone tumors in children. An interventional radiologist, guided by CT, inserts a small probe into the target area. An electrical current heats the tip of the probe, which destroys the tumor.

Sclerotherapy

Sclerotherapy is a way to treat blood vessels and lymph vessels that didn’t form properly. An interventional radiologist, guided by ultrasound, uses a needle to inject dye to see the vessel and medicine to shrink the vessel.

Thrombolysis

Thrombolysis breaks up blood clots that are limiting or blocking blood flow through an artery or vein. An interventional radiologist, guided by fluoroscopy, inserts a catheter into a blood vessel, threads it to the clot and injects dye in order to see the clot. Then they can inject medicine to dissolve the clot, or they can use a machine to spray the clot with saline to break it up and suction the pieces out.

Feeding tube and other access tube placement (G-tube, GJ-tube and NJ-tube)

Some children need to get food, medicine and other treatments to their stomach or intestines through a tube. Some tubes go through their skin into their stomach (G-tube) and possibly their small intestine (GJ-tube). Others go through their nose into their small intestine (NJ-tube) or through their skin into their large intestine (percutaneous cecostomy tube). An interventional radiologist, guided by X-ray or fluoroscopy, can place these tubes.

Vascular access/line placement

To make it easier on your child to receive medicine or nutrition into a vein or have blood drawn repeatedly, doctors may place a central line (in the chest) or peripherally inserted central catheter (in the arm or leg). An interventional radiologist, guided by ultrasound and fluoroscopy, can insert these lines through the skin.


We also offer many other services, including biopsy; placement of tubes to drain the chest, abdomen, bile ducts, gallbladder (cholecystostomy), kidneys (nephrostomy) or an abscess; dilatation of bile ducts, the urinary tract or the esophagus; arthrography and joint injections; lumbar puncture; lymphography and thoracic duct embolization; and percutaneous transhepatic cholangiography.