Interventional Radiology Treatments at Pacific Endovascular Clinic
At Radiology Associates Inc., our goal is always to give you the best possible results with the least amount of risk. When developing a treatment plan, we take your individual needs and health factors into consideration. Our team of doctors uses minimally invasive techniques to keep your recovery time at a minimum. The following are some of the treatments we offer at Pacific Endovascular Clinic:
Uterine Fibroid Embolization (UFE) – Offered at our Hawaii Practice
Fibroids are the most common tumor of the female genital tract. They are benign masses of fibrous and muscle tissue in the uterine wall and may cause heavy menstrual bleeding, pain in the pelvic region, and pressure on the bladder or bowel.
Between 20 and 40 percent of women 35 and older have uterine fibroids of significant size. They are the most frequent cause of hysterectomy in pre-menopausal women. About one-third of the hysterectomies performed annually in the U.S. are carried out due to fibroids.
Uterine fibroid embolization, also called uterine artery embolization, is a new treatment option available to women who suffer from uterine fibroids. It is an alternative to hysterectomy and has proven to be very successful at treating bleeding and other symptoms related to fibroids. In the past, this procedure was used to limit bleeding during surgical removal of fibroid tumors. When doctors realized that uterine fibroid embolization often eliminated the need for surgery, they began performing it as a stand-alone procedure. We work closely with skilled gynecologists to provide you with the best treatment possible. For futher information on Uterine Fibroid embolization, please visit http://www.drfibroid.com and or http://health.groups.yahoo.com/group/embo/.
Radiology Associates Inc., was one of the first interventional Radiology practices in the state of Hawaii to offer uterine fibroid embolization. Our staff is highly experienced in performing this procedure and pays careful attention to the personalized needs of our patients. We work closely with skilled gynecologists to provide you with the best treatment possible.
About UFE Treatment
If a pelvic examination suggests you may have uterine fibroids, our doctors will confirm the diagnosis through ultrasound or MRI. These procedures will allow us to determine the size and location of the lesions. If fibroids are causing bleeding and other side effects, you will have the option of undergoing uterine fibroid embolization at The Queens Medical Center in Honolulu, Hawaii.
Uterine fibroid embolization works by blocking blood flow to fibroids. This starves them of the blood they need in order to grow and causes them to shrink in size. The uterine fibroid embolization procedure takes about an hour and a half and is performed in a radiological suite. The patient is given a sedative and remains asleep for the entire procedure. After undergoing uterine fibroid embolization, patients are required to stay overnight for pain control, but can return home the next morning.
Following uterine fibroid embolization, patients will experience some degree of uterine cramping. They may also experience pelvic pain and discomfort, which should progressively decrease over two weeks. Patients will be likely to resume normal activity in five to seven days. Fibroids will become smaller, and symptoms of fibroids will decrease over several months.
Effect on Fertility
Since uterine fibroid embolization is relatively new, it is still unclear how the procedure affects fertility. However, there have been multiple reports of successful pregnancies following uterine fibroid embolization. A large study is needed to determine the exact effects on fertility. For now, a procedure known as a myomectomy is recommended to women who want to preserve fertility.
Uterine fibroid embolization has proven to be a safe and effective method for alleviating symptoms of fibroid disease. UFE is not harmful to the uterus, and fibroid reoccurrence following the procedure is rare. Most patients who undergo uterine fibroid embolization at our Hawaii practice report being satisfied with the results of the procedure.
Treatment for Back Pain
Both men and women are at risk for developing fractures in the spinal bone due to osteoporosis, but women are especially vulnerable. Researchers estimate that at least 25 percent of women over age 50 will develop one or more spine fractures. Spine fractures can cause a wide range of symptoms including chronic or severe back pain, limited mobility, and a curved spine. Once a spinal fracture occurs, a person becomes significantly more at risk for developing another. To detect spinal fractures, we read DEXA bone density scan data performed at the Queens Medical Center.
Traditionally, treatments for fractures of the spine caused by osteoporosis have included pain medication, bed rest, and back braces. In the present day, however, there are other options for patients suffering from back pain. At our Hawaii practice, patients can choose from two minimally invasive back pain treatments: Vertebroplasty and Kyphoplasty.
Vertebroplasty is a minimally invasive outpatient procedure that can be performed without general anesthesia. It involves using x-ray guidance to inject orthopedic cement into a fractured area of the spine. The cement mixture strengthens bones that have become porous due to osteoporosis. It also helps to stabilize fractures, providing Hawaii residents with almost instant relief from back pain.
Often, we perform vertebroplasty on patients after other treatment options, such as bed rest and pain medication, fail. If you are a possible candidate for this treatment, we will first clinically evaluate you using imaging such as spinal x-rays, a radioisotope bone scan, or magnetic resonance imaging. Once we confirm that you have a compression fracture that could benefit from vertebroplasty, you will have the option of proceeding with the therapy.
When you come in for the procedure, you will be asked to lie on your stomach, and a local anesthetic will be applied near your spinal fracture to numb your skin and muscle. Next, a hollow needle will be passed into the vertebral bone, and an orthopedic cement mixture will be injected into the spine. Throughout the procedure, your doctor will use x-rays to guide the needle and inject the cement. Following the procedure, you will need to continue lying down for two additional hours to ensure that the cement hardens completely. You will then be allowed to return home, provided you have a ride and are not overly frail.
Once home, you should remain in bed for 24 hours. For the next week you should refrain from heavy lifting or any strenuous activity, but may return to most of your normal daily activities. Many vertebroplasty patients notice their back pain disappears soon after leaving our Hawaii practice.
If you have a spinal fracture that is causing you back pain, contact Radiology Associates Inc., today.
Treatment for Tumors
Our practice also treats various kinds of tumors, including head and neck tumors, juvenile nasopharyngeal tumors, meningioma, and paraganglioma. Because surgery for removing tumors can lead to significant bleeding, we often perform embolization a few days prior to surgery. This minimizes bleeding during surgery, reducing the risk of complications. To perform embolization, we insert a catheter into the blood vessels that supply a tumor and inject materials to block this blood supply. We can also treat some types of tumors by placing a catheter into the artery that supplies the tumor and injecting chemotherapy drugs directly into the mass, rather than into the veins. This treatment is called chemoembolization.
Prostate Artery Embolization for Benign Prostatic Hyperplasia
Radiology Associates Inc. is currently the only group in the State of Hawaii offering Prostate Artery Embolization (PAE) for severe lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH) or an enlarged prostate in men. The minimally invasive procedure is an alternative to surgery. Patients are seen at our Pacific Endovascular clinic for a consultation prior to the procedure. A special CT of the pelvis called a CTA will be obtained for mapping of the prostate arteries prior to the procedure. The Prostate Artery Embolization (PAE) procedure will be performed in the Angiography department at the Queen’s Medical Center.
What is BPH?
A majority of men have an enlarged prostate in their 50s and 80-90% have it by the time they reach their 70s and 80s. Having an enlarged prostate can be uncomfortable, slowing down flow of urine and even affecting ejaculation. Common symptoms include increased frequency, feeling of incomplete emptying and waking up at night to urinate. These symptoms can be monitored by the IPSS score. The International Prostate Symptom Score (IPSS) is an eight-question written screening tool used to screen for, rapidly diagnose, track the symptoms of, and suggest management of the symptoms of benign prostatic hyperplasia (BPH).
If you are having symptoms and the diagnosis is enlarged prostate, you will want to talk to your urologist about the available treatment options, which range from surgery to medications. Add to that list a procedure worth having a conversation about with your urologist about called prostate artery embolization (PAE).
What Is Prostate Artery Embolization?
PAE is an outpatient procedure for blocking blood flow to the prostate by deploying microspheres into the prostate arteries. With reduced blood flow to the prostate, the prostate shrinks, relieving symptoms. The procedure involves inserting a tiny catheter into an artery in the upper thigh. The physician uses X-rays to guide the catheter to the prostate arteries. Tiny round microspheres are then administered to the prostate arteries, blocking blood flow to the gland and causing the prostate to shrink.
Benefits of PAE
Prostate artery embolization is one among several treatment options for men with severe urinary tract symptoms caused by an enlarged prostate. You should discuss with your doctor what is most appropriate for you.
Some potential advantages of PAE include:
• No hospitalization. The procedure is performed in an interventional radiology suite with the patient under twilight sedation. Patients are typically discharged three hours after the procedure.
• Minimal pain. The procedure requires a pinhole incision in right thigh only. Patients experience minimal discomfort during the procedure.
• Fewer side effects compared to TURP procedure including decreased sexual side effects.
Who Is a Candidate for PAE?
Our interventional radiologist works closely with urologists to screen men who are most likely to benefit from the procedure. PAE is covered by major insurance carriers.
Candidates for the procedure typically meet the following conditions:
• Are between the age of 45 and 85
• Have lower urinary tract symptoms, such as difficulty urinating, frequent urination or urinary retention requiring catheterization, caused by an enlarged prostate
• Have tried but not responded to six months of medication therapy or have significant side effects from medication such as dizziness, fatigue or sexual dysfunction
• Have been screened for prostate cancer risk, including a prostate-specific antigen (PSA) test
If you think you are a candidate for PAE or have questions, please contact Pacific Endovascular at 748.4488 and schedule an appointment to discuss the PAE procedure.
Treatments for Other Vein, Artery, and Blood Vessel Problems
The Interventional Radiologists at our Honolulu practice offer various other minimally invasive vascular treatments. Many of the image-guided treatments involve threading small wires or catheters through the veins.
Some of the vascular conditions we treat include:
– Traumatic Vascular Lesions
– Blood Clots
– Atherosclerotic Disease
– Prostate Artery Embolization
Please contact our Honolulu practice for more information about the vascular treatments we offer.