Heart and Vascular Institute – Cardiovascular and Interventional Radiology
Patients with a variety of disease processes in the body are likely to see an interventional radiologist during their treatment. With the ability to perform minimally invasive procedures using catheters and wires under X-ray guidance, interventional radiologists have a made a large impact on how patients are cared for in today’s health care systems.
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The interventional specialists at Penn State Heart and Vascular work with many of the specialists in the Institute and at the Hershey Medical Center to ensure that seamless, expedient world-class healthcare is received by each and every patient. Led by the Chief of Interventional Radiology, Peter Waybill, MD, the division of Cardiovascular and Interventional Radiology is the most all-encompassing interventional service in central Pennsylvania.
Percutaneous Oncological Treatments
Penn State Heart and Vascular Institute has long been the leader in the treatment of hepatic malignancies with chemotherapeutic embolization (trans-arterial chemoembolization or TACE) and radiotherapeutic embolization (Y90). With a large body of literature demonstrating improved survivals in selected patients, the use of chemoembolization and radioembolization has become a major weapon against the poor outcomes associated with certain tumors. Working with the oncologists and the oncological surgeons of the Penn State Cancer Institute, patients are offered state-of-the-art health care using a very effective team approach.
Additionally, percutaneous ablation techniques have demonstrated promise as an adjunct to current regimens for the treatment of limited malignant disease in the liver, but also in the kidneys, lung and the skeletal system as well. Using a small probe, under CT scan guidance, lesions are ablated using either a radiofrequency technique, microwave technique or a cryoablation technique, all currently offered at the Heart and Vascular Institute.
By working closely with the other programs in the Heart and Vascular Institute, the interventional radiologists are able to diagnose and percutaneously treat venous thrombosis, easily with advanced techniques such as catheter directed venous thrombolysis (CDVT).
With the advent of optional IVC filters (ones that can be removed at a later date or remain as permanent filters), options for the treatment of patients at risk for pulmonary embolism have expanded. These filters are placed via a percutaneous approach either from the femoral or the jugular veins. When the patients are anti-coagulation candidates or are no longer at risk for DVT / PE, the filters can be removed from the jugular vein in an outpatient procedure. As one of the largest optional filter practices in the nation, the specialists at the Penn State Heart and Vascular Institute can offer solutions for almost any patient scenario.
Learn more about the benefits of IVC filters for the treatment of patients in the Penn State Medicine article "The journey of an IVC filter—from life-saving to life-altering".
Women’s Health Interventions
Started in 1999, the Uterine Fibroid Embolization (UFE) service, in conjunction with Penn State Obstetrics and Gynecology, has been able to offer this successful treatment method to those patients who are hesitant to undergo a hysterectomy. It represents one possible treatment method in a whole gamut of procedures offered today in Women’s Health. Two other services offered as part of Women’s Health Interventions include Fallopian Tube Recanalization for those women unable to achieve pregnancy secondary to fallopian tube blockages. Performed as an outpatient procedure, the procedure has an excellent risk/benefit profile and has helped many women achieve pregnancy. Pelvic Congestion Syndrome, a clinical diagnosis of pelvic pain based on the anatomic finding of a distended gonadal vein represents one of the most difficult entities to diagnose. Interventional radiologists are able to provide treatment options to those patients who do not wish to (or may not be able to) have an open surgery.
Lower Extremity Venous Disease
The varicose vein treatment service, coordinated by Les Scorza, MD, includes clinical consultations, as well as a wide spectrum of varicose vein evaluation and intervention modalities. Preliminary vascular ultrasound is performed at initial consultation and then more formal duplex ultrasound evaluation is arranged through the Vascular Laboratory. Treatment options include endovenous laser ablation, microphlebectomy and injection sclerotherapy (including ultrasound-guided sclerotherapy for perforators when appropriate). Additional more complex procedures are offered in conjunction with the Vascular Surgery service when needed. Many procedures are done with only local anesthesia, although intravenous sedation is available. Several hundred cases have been performed over the last two years with excellent results.
Atherosclerotic Occlusive Disease
Causing arterial insufficiency in almost any organ system of the body, atherosclerotic occlusive disease can frequently be treated in a percutaneous fashion. Using advanced imaging techniques for diagnosis including CT Angiography (CTA) and MR Angiography (MRA), the specialists in the Heart and Vascular Institute can treat lesions using a combination of balloons and stents to improve blood flow to the affected system. Most procedures are performed on an outpatient basis with only a short, overnight stay. With more than 500 stents placed in almost all the organ systems, the specialists at the Heart Vascular Institute are able to determine which lesions would be best treated with a percutaneous method or an open method.
Arterial Vascular Disease Diagnosis and Treatment Services
- Noninvasive Vascular and Cardiac Imaging
- CT Angiography
- MR Angiography
- Diagnostic Arteriography
- Peripheral Vascular Disease
- Diagnostic Peripheral angiography
- Arterial angioplasty and stent placement
- Cerebral Vascular Disease
- Diagnostic Carotid Angiography
- Carotid Artery Stent Placement
- Renovascular Disease
- Diagnostic Renal angiography
- Renovascular Hypertension
- Renal Artery Angioplasty and Stent placement
Venous Vascular Disease Diagnosis and Treatment
- Diagnostic venography
- Treatment of Varicose veins
- Inferior vena cava filter placement and removal
- Treatment of Pelvic congestion syndrome
- Treatment of Varococele
- Treatment of ilio femoral DVT
- Treatment of venous malformations or vascular malformations
- Venous access (catheter) placement procedures
- Dialysis access management
Nonvascular Disease Diagnosis and Treatment
- Radiofrequency and microwave ablation of tumors
- Endoscopic treatment of biliary stone disease
- Management of benign and malignant strictures of the biliary and urinary system
- Gastrostomy tube placement
- Uterine artery embolization
- Chemoembolization and radioembolization of tumors
- Transjugular Intrahepatic Portosystemic shunt (TIPS)
- Transjugular liver biopsy