Thomas Jefferson University Hospital
 
DIVISION OF CARDIOVASCULAR/INTERVENTIONAL RADIOLOGY

Procedures

The division performs over 6,500 procedures each year, including more than 900 procedures to treat patients with arterial or venous disease. These include procedures such as balloon angioplasty, vascular stent placements, TIPS (transjugular intrahepatic portosystemic shunt) procedures, and IVC filters. Combined surgical and interventional procedures performed in the operating room are becoming more frequent, partially because of the number of patients undergoing stent-grafts placements for aortic aneurysms. Also the number of chemoembolization procedures (and more recently immunoembolizations) for patients with inoperable tumors, and  uterine fibroid embolizations are rapidly increasing.

Non-vascular procedures account for approximately 25 percent of cases. Most of these procedures are based on techniques used in the vascular system which are utilized to treat patients with blockages in their bile ducts or ureters, or to provide drainage for patients with intra-abdominal abscess.

The following is a list is a sample of the types of procedures performed by the CVIR division:

  • thoracic aortogram
  • upper extremity arteriogram
  • carotid arteriogram
  • intercostal, lumbar or bronchial arteriogram
  • abdominal aorta
  • renal arteriogram
  • adrenal arteriogram
  • hepatic arteriogram
  • splenic arteriogram
  • pancreatic arteriogram
  • mesenteric arteriogram
  • pelvic arteriogram
  • lower extremity arteriogram
  • Intra-operative arteriogram
  • intravascular ultrasoundballoon angioplasty, aorta
  • balloon angioplasty, upper extremity artery
  • balloon angioplasty, renal or visceral artery
  • balloon angioplasty, iliac artery
  • balloon angioplasty, fem/pop artery
  • balloon angioplasty, tib/peroneal artery
  • vascular stent placement
  • thrombectomy, renal or visceral artery
  • thrombectomy, upper extremity artery
  • thrombectomy, iliac or femoral artery
  • thrombectomy, popliteal or tibial artery
  • thrombectomy, bypass graft
  • thrombolysis, transcatheter
  • herapeutic infusion, transcatheter
  • embolizations, transcatheter arterial occlusion
  • thrombin injection for vascular occlusion
  • chemoembolization, transcatheter intra-arterial
  • chemotherapy, arterial infusion
  • atherectomy, upper extremity artery
  • atherectomy, renal artery
  • atherectomy, visceral artery
  • atherectomy, iliac artery
  • atherectomy, fem/pop artery
  • therectomy, tibeoperoneal
  • intraoperative balloon angioplasty, aorta
  • intraoperative balloon angioplasty, upper ext artery
  • intraop balloon angioplasty, renal or visceral art
  • intraop balloon angioplasty, iliac artery
  • intraop balloon angioplasty, fem/pop artery
  • intraop balloon angioplasty, tib/peroneal artery
  • vascular stent, intraop
  • endovascular graft, abd aorta
  • endovasc graft, aortoiliac, bifurcated
  • endovascular graft, descending thoracic aorta
  • endovascular graft, subclavian
  • endovascular graft, femoropopliteal
  • endovascular graft, iliofemoral
  • IVC filter placement
  • balloon angioplasty, venous
  • thrombectomy of dialysis graft
  • thrombectomy, vena cava, iliac, fem/pop
  • thrombectomy, axillary, subclavian veins
  • thrombectomy, pulmonary
  • foreign body retrieval, intravascular
  • varicocele embolization
  • TIPS (transjugular intrahepatic portosystemic shunt)
  • central venous catheter placement
  • central venous catheter reposition
  • PICC line placement
  • implantable venous access, placement
  • implantable venous access, revision
  • implantable venous access, removal
  • insertion of cannula for hemodialysis
  • declot cannula
  • declot of venous catheter by thrombolysis
  • insertion of flow directed catheter
  • central venous catheter check
  • venous access port check
  • superior vena cavagram
  • upper extremity venogram, unilateral
  • dialysis shunt study
  • internal jugular venogram
  • inferior vena cavagram
  • renal venogram
  • adrenal venogram
  • hepatic venogram
  • splenoportography, transhepatic
  • splenoportography, arterial
  • splenoportography, direct
  • pelvic venogram
  • lower extremity venogram
  • pulmonary angiogram
  • liver biopsy, transvenous
  • invasive hemodynamic evaluation, venous
  • selective organ vein sampling
  • percutaneous gastrostomy placement
  • exchange of gastrostomy tube
  • jejunostomy tube placement via gastrostomy
  • percutaneous feeding tube placement
  • placement of long gastrointestinal tube
  • esophageal dilatation
  • esophageal stent placement
  • rectal dilatation
  • rectal stent placement (includes dilatation)
  • sigmoid stent placement
  • colon stent placement
  • small bowel stent placement
  • injection of sinus tract or fistula
  • abscess/cyst injection via indwelling catheter
  • exchange/reposition of drainage catheter
  • aspiration of fluid for analysis
  • drainage of pancreatic pseudocyst
  • abscess or cyst drainage, liver
  • abscess drainage, peritoneal
  • abscess drainage, retroperitoneal
  • abscess drainage, subdiaphragmatic
  • abscess drainage, appendiceal
  • abscess drainage, thigh
  • abscess drainage, pelvis/hip
  • abscess drainage, renal or perirenal
  • drainage, deep/complicated subQ abscess
  • intraperitoneal catheter placement
  • cyst sclerosis or tumor ablation
  • injection of air/contrast, peritoneal cavity
  • intralesion injection of chemotherapy
  • biliary drainage, external
  • biliary drainage, internal
  • cholangiogram, transhepatic needle
  • cholangiogram, catheter
  • exchange of biliary drainage catheter
  • revision/reinsertion transhepatic catheter
  • removal of internal biliary stent
  • biliary biopsy, transcatheter
  • dilatation of biliary stricture
  • dilatation of biliary stricture with stent
  • biliary stone removal
  • cholecystostomy placement
  • insertion of chest tube - pneumothorax
  • chemical pleurodesis
  • abscess drainage, thorax, empyema

The following cases illustrate some of the procedures listed above:

  1. Lower extremity arteriogram in patient with peripheral vascular disease
  2. Renal arteriogram in patient with vascular tumor
  3. Mesenteric arteriogram in patient with gastrointestinal bleeding, embolization
  4. Arterial stent placement
  5. Abscess drainage
  6. Biliary catheter drainage
  7. Chemoembolization of liver tumor
  8. Uterine fibroid embolizations